肘前入路可吸收螺钉治疗肱骨小头骨折

Treatment of capitulum humeri fractures with absorbable screw internal fixation via anterior elbow approach

目的探讨采用肘前入路治疗肱骨小头骨折内固定疗效。方法9例新鲜闭合性Ι型肱骨小头-滑车骨折,未合并血管、神经损伤。手术时间为伤后3～5d。采用肘前入路直视下复位骨折,分别于肱骨小头、滑车由前向后置入可吸收螺钉固定治疗肱骨小头骨折。结果9例患者切口均一期愈合,术后X线片显示骨折解剖复位。骨折临床愈合时间平均为4周。随访时间最短6个月～3年。无血管损伤、神经损伤、肘关节骨化性肌炎、创伤性关节炎、肱骨小头缺血坏死等并发症。Morrey肘关节功能评定:优,6例;良3例。结论采用肘前入路行肱骨小头骨折切开复位内固定术,可直视下暴露骨折面和骨折块,准确复位,用可吸收螺钉有效固定,早期行肘关节主动伸屈功能锻炼,疗效较佳。

Objective To evaluate the clinical results of internal fixation with absorbable screw for treatment of capitulum humeri fractures through anterior elbow approach Methods Nine patients with type Ⅰ capitulum humeri-trochlea fracture were treated with absorbable screw. The fractures were all fresh and closed without nerve and blood vessel injury. The operation was performed in 3 to 5 days after injury. Results The patients were followed up for 6 months to 3 years. X-ray film showed anatomic reduction in all cases. The healing time was 4 weeks in average. No postoperative complications such as nerve and blood vessel injury, myositis ossificans, post-traumatic arthritis, vascular necrosis of capitulum humeri were found. Morrey scores were excellent in 6 cases and good in 3 cases. Coclusion Internal fixation with absorbable screw for treatment of capitulum humeri fractures through anterior elbow approach has the advavtages of visual and correct reduction, early functional exercise and excellent clinical outcomes.