肱骨髁间骨折两种入路的疗效比较

Comparative effectiveness of two operative approaches to humeral condyle fracture

目的评价尺骨鹰嘴截骨入路、肱三头肌舌状瓣入路治疗肱骨髁间骨折的临床疗效。方法2004年8月—2007年8月,手术治疗肱骨髁间骨折27例,按骨折AO/ASIF分型:C1型6例,C2型13例,C3型8例。分别尺骨鹰嘴截骨、肱三头肌舌状瓣切口入路,行切开复位钢板内固定术。结果27例患者随访8～12个月,平均10.4个月,骨折全部愈合,平均愈合时间4.6个月。肘关节功能根据Aitken和Rorbeck的肘关节功能评定标准进行评定,尺骨鹰嘴截骨入路组优良率82.4%,经肱三头肌舌状瓣入路优良率60%。结论经尺骨鹰嘴截骨入路的疗效明显优于经肱三头肌舌状瓣入路。

Objective To report the outcomes of two operative approaches（approach with olecroanon osteotomy or musculi triceps brachii tongue-shaped flap） for humeral condyle fracture.Methods Twenty-seven patients with humeral intercondylar fracture were treated with fixation in our hospital from August 2004 to August 2007.By AO/AISF classification,the fractures were classified as type C1（n=6）,type C2（n=13）,and type C3（n=8）.After treated with one of the two operative approaches,all the patients underwent open reduction and internal plate fixation of fracture.Results All the patients were followed up for 8-12 months,with an averge of 10.4 months.All the fractures were healed,with an averge healing time of 4.6 months.According to the Aitken and Rorabeck＇s scoring system,the elbow function was excellent and good in 82.4% of the patients treated with olecroanon osteotomy approach,and in 60% in those treated with the other approach.Conclusion For humeral condyle fracture patients,olecroanon osteotomy approach is better than musculi triceps brachii tongue-shaped flap approach.