手术治疗肱骨髁间骨折115例疗效评价

Curative Effect of Proper Price on Surgical Treatment for Supracondylar Fracture of Humerus in 115 Cases

目的总结手术治疗肱骨髁间骨折的效果,并对手术时机、入路、固定方式及可能影响疗效的因素进行探讨。方法对115例不同类型肱骨髁间骨折采用手术恢复肘关节结构及功能,分别采用肱三头肌在尺骨鹰嘴止点剥离、内外联合切口、肘后肱三头肌舌形或V形肌瓣、尺骨鹰嘴截骨入路显露肱骨髁间,骨折复位及固定。结果平均随访36个月(8～60个月),采用疗效评价参照Cassebaum标准进行功能评价。结论按Riseborough分类,Ⅰ型及Ⅱ型可选择内外或内外联合切口,可在不损伤伸肘装置下满足骨折复位及固定的需要。Ⅲ型及Ⅳ型以经鹰嘴入路作为首选,可以满足骨折复位及固定的需要,同时对肘后肌群干扰最小,有利于关节功能的恢复。选择合适的手术入路、重建关节面、有效的固定及早期活动是治疗成功的关键。

Objective To study the effect of supracondylar fracture of humerus treated by operation, and to discuss the influence factors about surgical timing, approach, fixed manner and the efficacy. Methods Of 115 cases of different types of supracondylar fracture of humerus with elbow surgery to restore the structure and function, respectively triceps olecranon only point in the spin-off, inside and outside the incision, the posterior elbow triceps tongue-shaped or V-shaped muscle flap, olecranon osteotomy revealed humeral condylar fracture reduction and fixation. Result Average with visit for 36 months（8-60month）. adoption curative effect evaluation according to Cassebaum standard carry on function evaluation. Conclusion According to Riseborough classification, Ⅰ and Ⅱ type choice outside or inside and outside the incision can be installed without damage under the elbow fracture reduction and fixed to meet the needs. Type Ⅲ and type IV to by the olecranon as the preferred approach to meet the needs of fracture reduction and fixation, while the posterior elbow muscles cause the least disturbance is conducive to joint function recovery. Select the appropriate surgical approach, reconstruction articular surface, an effective and early activities of the fixed key to successful treatment.