成人肱骨远端复杂粉碎性骨折手术治疗分析

目的:探讨成人肱骨远端复杂粉碎性骨折应用双钢板内固定的手术方法和治疗效果。方法:本院自2005年1月～2009年6月应用双钢板内固定治疗成人肱骨远端复杂粉碎性骨折26例,男19例,女7例,年龄15～74岁,平均59岁。骨折按AO/ASIF分型法分型,均为C型,其中C1型7例,C2型13例,C3型6例。采用肘后正中切口,行切开复位双钢板螺钉内固定治疗。早期进行功能锻炼。定期随访并手术后1、2、6个月拍片,了解骨折愈合和关节功能恢复情况。结果:26例均获得随访,随访时间11～28个月,平均16个月,26例均骨折愈合,23例肘关节功能恢复良好,1例骨化性肌炎形成,2例关节僵硬,无骨不连及尺神经损伤病例,优良率88.5%。结论:成人肱骨远端复杂粉碎性骨折,结构复杂,手术难度大,术中充分显露,关节面解剖复位,双钢板螺丝钉坚强的内固定治疗,有利于肘关节的早期活动和防止粘连,能有效地恢复肘关节功能,是一种治疗成人肱骨远端复杂粉碎性骨折较理想的方法。

Objective：Discuss the surgical methods and treatment in complex fractures of adult distal humerus with double-plate fixation.Method：From January 2005~June 2009,26 cases of complex fractures of adult distal humerus were treated with double-plate fixation,19 males and 7 females,aged from 15 to 74 years,mean 59 years.According to AO/ASIF classification,all cases are C-type,in which 7 cases of type C1,C2 in 13 cases,C3 in 6 cases.With posterior elbow incision, all cases were treated in open reduction with double-plate screw fixation,also with early functional exercises.We followed-up1,2,6 months x-ray films after surgery,understanding fracture healing and joint function recovery.Results：26 patients were followed-up 11 to 28 months,on average 16 months,26 patients fractures were healed,23 cases of elbow joint function recovered well,and 1 case of myositis ossificans formation,2 cases of stiff joints,no nonunion and ulnar nerve injury cases,the fine rate was 88.5%.Conclusion：The complexity of adult distal humerus fractures,as the complex structure,difficult to surgery,the method of intraoperative fully revealed,anatomical reduction of articular surface,strong double-plate screw fixation,which was conducive to the early activities of the elbow and prevent adhesion,can be effective in restoring function of the elbow.It was a good method to treat the complex fractures of adult distal humerus