锁定加压双接骨板治疗肱骨远端C型骨折

Treatment of AO type C distal humerus fracture with locking compression plate

目的探讨切开复位LCP双接骨板内固定治疗肱骨远端C型(AO分型)骨折的临床疗效。方法对21例肱骨远端C型骨折采用切开复位LCP双接骨板内固定治疗。术后3 d开始保护性功能锻炼。按照Mayo肘关节功能评分系统(MEPS)及X线片评估术后疗效。结果患者均获随访,时间18～43个月,均骨性愈合。末次随访时肘关节平均活动度:屈伸87°±3°,屈曲114°±4°,伸直27°±6°,旋前65°±4°,旋后67°±5°。肘关节Mayo功能评分:55～100(87±4)分,优13例,良3例,可4例,差1例。术后并发症:4例出现暂时性尺神经麻痹,1例关节僵硬,1例有创伤性关节炎表现。结论切开复位LCP双接骨板内固定治疗肱骨远端C型骨折能提供坚强内固定,允许早期功能锻炼,临床疗效满意。

Objective To investigate the effects of treating distal humeral fracture of AO type C with open reduction and locking compression plate（LCP） fixation. Methods 21 cases of type C distal humerus fracture were treated with open reduction and LCP fixation. Their elbows were began exercise 3 days after the operation. Functional results were evaluated according the Mayo elbow performance score（MEPS）. Results All patients were followed up for 18 -43 months and all fractures achieved complete union. The average of elbow degrees were as follows ： extension 87° ±3 °, flexion 114°±4° ,supination 65° ±4°, and pronation 67°± 5°. According to MEPS, 13 cases were graded as excel- lent, 3 good, 4 fair, and 1 poor. Postoperative complications： 4 cases had transient ulnar nerve paralysis, 1 slight symptoms of traumatic arthritis, and 1 elbow stiffness. Conclusions Open reduction with LCP double plate fixation for distal humerus fractures can provide strong type C fixation, allow early functional exercise with satisfactory clinical curative effect.