经肘关节双侧入路双钢板治疗C型肱骨远端骨折

Treatment of Type C Fracture of Distal Humerus with Dual-plate via Elbow Bilateral Approach

目的:评价经肘关节双侧入路双钢板治疗C型股骨远端骨折临床疗效。方法:2006年1月-2009年1月,采用开放复位、双钢板内固定治疗C型肱骨远端骨折36例,其中男23例,女13例;年龄18～55岁,平均36岁。骨折按AO/ASIF分类法,C1型16例,C2型12例,C3型8例。术后随访时间12～22个月,平均15个月,根据改良Cassebaum肘关节评分标准进行临床疗效评定。结果:按改良Cassebaum肘关节评分标准:优22例,良8例,可5例,差1例,优良率83.3%。1例发生皮瓣坏死。无螺丝钉松动、断裂及内固定失败发生。结论:1.肘关节双侧入路双钢板治疗C1、C2型肱骨远端骨折固定牢靠,保全伸肘装置,允许早期主动功能锻炼,能最大程度恢复肘关节的功能。2.肘关节双侧入路双钢板治疗C3型肱骨远端骨折显露有一定困难。

Objective： To evaluate clinical effect of treatment of type C fracture of distal humerus with dual-plate via elbow bilateral approach.Method：36 patients（23 males and 13 females） with type C fracture of distal humerus were treated with surgical reduction and internal fixation with dual-plate,from January 2006 to January 2009.The mean age of the patients was 36 years（range,18 to 55 years）.According to AO/ASIF classification,16 cases were type C1,12 cases were type C2 and 8 cases were type C3.The average duration of follow-up was 15 months（range,12 to 22 months） for all patients.The clinical results were assessed according to the modified Cassebaum elbow score.Result：According to the Cassebaum elbow score,22 cases were excellent,8 cases were good,5 cases were fair and 1 case was poor,and the satisfactory rate was 83.3%.Necrosis of skin flap was occurred in one case.No screw sliding,dislodging or fixation failure was occurred for all patients.Conclusion：The treatment of type C1and C2 fracture of distal humerus with dual-plate via elbow bilateral approach not only maintain reliable fixation and reserve the extension of elbow installment,but also allow early function exercise to restore the elbow joint function to the greatest;the fracture line is difficulty to be exposed in type C3 fracture by this way.