肱骨髁间、髁上粉碎性骨折治疗体会

Treatment Experience of Comminuted Fracture of Intercondylar Humerus and Supracondylar

目的:探讨肱骨髁间、髁上粉碎性骨折患者采用后路截断尺骨鹰嘴入路暴露,交叉克氏针结合"Y"形钢板的手术技巧及临床疗效。方法:2007—2010年收治21例肱骨髁间、髁上粉碎性骨折病例,男16例,女5例;年龄17—74岁,平均45.5岁;右侧11例,左侧10例;新鲜骨折17例,陈旧性骨折4例;车祸8例,摔伤7例,高处坠落伤6例。结果:所有患者随访1-3年,平均2年。21例均骨性愈合,无明显肘内、外翻畸形。4例延迟愈合,经二期切开同种异体骨或者自体骨植骨,均骨性愈合。术后肘关节功能按casseban评分系统评分:优15例,良4例,可1例,差1例。结论:肱骨髁间、髁上粉碎性骨折采用尺骨鹰嘴截骨入路,可充分暴露骨折端情况,视野清楚,有助于术中复位固定,是一种值得推广的肱骨髁间、髁上粉碎性骨折手术入路。

Objective： The Objective of the essay was to explore the surgical techniques and clinical effect of comminuted fracture of intercondylar humerus and supracondylar patients who were treated by posterior truncation olecroanon approach exposure and Kirschner wire combined with ＂Y＂ steel plates. Methods： We hospitalized 21 comminuted fracture of intercondylar humerus and supracondylar cases from 2007 to 2010, and there were 16 male cases and 5 female cases. Their age varied from 17 to 74, and the average age was 45.5. Among these, there were 11 right fractures, 10 left fractures; 17 fresh fractures cases, 4 chronic fractures cases; 8 car accident cases, 6 high altitude falling injury cases. Results： All patients were followed up for 1-3 years, and the average follow-up year is 2. All cases were radiographic union without elbow and valgus deformity, and 3 late healed cases were radiographic union after allograft or autogeneous bone grafts. According to casseban scoring system of postoperative functional evaluation for elbows, there were 14 excellent cases, 5 good cases, 1 passable case and 1 bad case. Conclusion： posterior truncation olecroanon approach exposure can fully exposure the fracture condition which helped reset and fix in operation with clear eye view and were worth spreading.