肱骨髁间骨折的手术治疗

Surgical Treatment of Intercondylar Fractures of Humerus

目的探讨肱骨髁间骨折采用不同手术方式治疗的临床效果。方法对118例肱骨髁间骨折患者行肘后路切口,采用3种手术方式对骨折进行整复,运用重建板、＂Y＂型钢板、前臂加压钢板或多根克式针张力带钢丝作内固定。结果 118例患者术后均获随访,随访时间3-22月,平均17个月。肘关节功能评分参照HSS评分标准,优71例,良34例,可11例,差2例,优良率为89%,术后切口均甲级愈合,无骨不连发生。术后桡神经损伤者均在6-12个月内恢复桡神经功能,尺神经损伤者在8-24个月恢复尺神经功能。结论肱骨髁间骨折是一种严重的关节内骨折。采用肘后路切口对骨折进行整复,坚强内固定,能较大限度恢复肘关节功能。

Objective To investigate the clinical efficacy of different surgical treatment of intercondylar fractures of the humerus.Methods A total of 118 patients with intercondylar fractures of the humerus were treated with open reduction and internal fixation.Posterior incision was used to expose the elbows.Intercondylar fractures of the humerus were fixed using reconstruction plates,＂Y＂ plates,and forearm compression plates or Kirschner wires plus tension band wires.Results All patients were followed-up for an average of 17 months（range 3 to 22 months）.According to HSS elbow score criterion,results were excellent in 71 patients,good in 34,fair in 11,and poor in 2.The rate of excellent and good results was 89%.All the incisions were well healed without nonunion.The recovery of radial nerve function occurred within 6 to 12 months and the recovery of ulnar nerve within 8 to 24 months.Conclusion Surgical treatment of intercondylar fractures of the humerus with posterior elbow incision and rigid internal fixation can recover the elbow function to a greater extent.