解剖型锁定钢板内固定治疗肱骨远端C型骨折

Internal Fixation of Anatomical Locking Plate for Type C Fractures of Distal Humerus

目的探讨应用解剖型锁定钢板内固定治疗C型肱骨远端骨折的疗效。方法肱骨远端C型骨折28例,按AO/ASIF分类:C1型10例,C2型15例,C3型3例;均采用采用尺骨鹰嘴截骨入路,解剖型锁定钢板内固定。受伤至手术时间平均5.8 d(2 h^10 d)。结果术后28例均获随访,平均20(2~30)月。骨折愈合时间平均3.5(2~10)个月。根据Cassebaum评分系统评定肘关节功能:优10例,良12例,可5例,差1例,优良率为78.6%,结论采用尺骨鹰嘴截骨入路,早期切开解剖复位、解剖型钢板内固定及早期有计划地康复训练治疗肱骨远端骨折,复位良好,固定可靠,能最大限度地恢复肘关节功能。

Objective To evaluate the effect of internal fixation of anatomical locking plate in the treatment of type C fractures of distal humerus.Methods 28 distal humeral fractures patients were treated by open reduction and internal fixation with anatomic locking plate via the olecroanon V-shaped osteotomy approach.According to AO/ASIF classification,there were type C1 fracture in 10 cases,type C2 in 15 cases and type C3 in 3 cases.The operation was performed in 2 hours to 10 days after injury with an average duration of 5.8 days.Results 28 cases were followed up for 2 to 30 months with an average of 20 months.The mean fracture healing duration was 3.5 months（ranged from 2 to 10 months）.According to Cassebaum scoring system,the outcomes showed excellence in 10 cases,good in 12 cases,fair in 5 cases and false in 1 case,and the fineness ratio was 78.6%.No infection and cutaneous necrosis occurred.The 2 cases with radial nerve injury were recovered gradually in 3 months after the operation.Conclusion The management of early open reduction,internal fixation with anatomic locking plate via the olecroanon V-shaped osteotomy approach and early planned rehabilitaion training can achieve satisfactory reduction and reliable fixation and restore the elbow joint function as possible for type C fractures of distal humerus.