三种不同内固定方法治疗肱骨外髁骨折的疗效比较研究

Comparative study on the efficacy of three different fixation methods for humeral condylar fracture

目的比较分析三种不同内固定方法治疗肱骨外髁骨折的疗效,旨在为临床治疗提供进一步的指导依据。方法选择我院2009年1月～2010年1月采用Bold螺钉治疗肱骨外髁骨折患者30例,设为A组,另选择同期行空心螺钉固定治疗的肱骨外髁骨折患者30例,设立为B组,以及同期行切开复位克氏针固定治疗的肱骨外髁骨折患者30例,设立为C组,观察比较各组患者术后1、3个月的疗效,以及术后1个月肘关节活动范围、骨折愈合时间、平均住院时间、术后并发症情况。结果各组均顺利完成手术,各组术后3个月的优良率均较术后1个月明显提高,且A组术后3个月的优良率达96.7%,明显高于C组同期,差异均有统计学意义(均P<0.05)。A组术后1个月肘关节活动范围明显大于其他两组,A组治疗后骨折愈合时间快于其他两组,差异均有统计学意义(均P<0.05)。随访6～24个月,A组术后并发症情况明显好于C组(P<0.05)。结论 Bold螺钉治疗肱骨外髁骨折疗效明显优于空心螺钉内固定以及克氏针内固定,具有手术优良率高、骨折愈合快、术后并发症少等优点,值得推广和应用。

Objective To compare the efficacy of three different fixation methods for humeral condylar fracture,and to provide further guidance for clinical treatment.Methods 30 patients with Bold screw humeral condyle fractures were chosen as group A in our hospital from January 2009 to January 2010,and other 30 patients with concomitant hollow screw fixation of the humeral condyle fracture were chosen as group B,and 30 cases with the treatment of humerus underwent open reduction and Kirschner wire fixation over the same period were chosen as group C;the efficacy of the treatment after surgery 1 and 3 months,the range of motion,fracture healing time,the average length of stay,postoperative complications were compared.Results The excellent rates of 3 months after surgery in each group were found all better than those of 1 month and the excellent rate of 3 months after surgery in group A was 96.7% which was higher than that in group C in the same period,the differences were all statistically significant（all P 0.05）.The range of motion in Group A was found greater than that in other two groups,postoperative fracture healing time in group A was found faster than that in other two groups,the differences were all statistically significant（all P 0.05）.Followed up for 6-24 months,postoperative complications of group A was found better than those in group C（P 0.05）.Conclusion Bold to screw humeral condyle fractures has significantly more superiority than the hollow screw fixation and Kirschner wire fixation such as higher excellent rate,shorter time of fracture healing and fewer complications,it is worthy of promotion and application.