两种入路治疗肱骨髁间骨折的疗效分析

Effect of Double Approaches on Comminuted Intercondylar Fracture of Humerus

目的比较经尺骨鹰嘴截骨入路与经肱三头肌舌状瓣入路治疗肱骨髁间骨折的疗效。方法对41例肱骨髁间骨折患者随机分为两组,截骨组21例、舌状瓣组20例,分别经尺骨鹰嘴截骨、肱三头肌舌状瓣切口入路,行切开复位钢板内固定术。结果全部患者随访6～18个月,平均11.8个月,骨折全部愈合,平均愈合时间4.5个月。两组患者经Cassebaum评分系统评定术后肘关节功能,截骨组的优良率明显高于舌状瓣组,差异显著具有统计学意义(P<0.05)。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 study the effect of olecranon osteotomy approach and triceps tongue-shaped flap approach on comminuted intercondylar fracture of humerus. Methods Fourty one patients with comminuted intercondylar fracture of humerus were divided into two groups,21 cases with osteotomy group and 20 cases with tongue-shaped flap group,receiving the olecranon osteotomy approach and triceps tongue-shaped flap approach respectively,with open reduction and internal fixation. Results All patients were followed up in 6-18 months with the average of 11.8 months. The fracture has been recovered,with the average of 4.5 months. After being evaluated by Cassebaum rating system on the postoperative elbow joint functions,the excellent rate of osteotomy group is significantly higher than the tongue-shaped flap group,with significantly statistical difference （P〈0.05）. Conclusion The effect of olecranon osteotomy approach is significantly better than the triceps tongue-shaped flap approach.