双钢板在肱骨远端C型骨折的应用及影响预后的相关因素分析

Research of dual plate applied in C-type distal humerus fracture and influencing factors of prognosis

目的探讨双钢板应用于肱骨远端C型骨折的临床疗效及影响骨折预后的相关因素。方法将本院收治的84例肱骨远端C型骨折的患者按治疗方法分为双钢板固定组及Y型钢板固定组,2组患者均给予经尺骨鹰嘴截骨入路切开复位内固定术后再分别采用双钢板(双钢板固定组)及Y型钢板固定(Y型钢板固定组)。治疗完成后比较2组患者的改良cassebaum肘关节评分、并发症发生率、骨折愈合时间,并分析影响患者预后的相关因素。结果双钢板固定组治疗的优良率显著高于Y型钢板固定组(P<0.05),而骨折愈合时间、并发症发生率显著低于Y型钢板固定组(P<0.05);合并伤、骨折类型、内固定方法、术后功能锻炼是影响预后的独立因素。结论采用双钢板的经尺骨鹰嘴截骨入路切开复位内固定术对于肱骨远端C型骨折患者疗效肯定,术后应及早功能锻炼,促进肘关节功能恢复。

Objective To investigate the clinical efficacy of dual plate in treatment of C-type distal humerus fracture and influential fac- tors of prognosis. Methods 84 cases of patients with C-type distal humerus fracture in our hospital were randomly divided into dual plate fix- ation group and Y-shaped plate fixation group, and both of the two groups were given open reduction and internal fixation of oleeranon osteoto- my. The improved cassebaum elbow score, incidence of complications, and fracture healing time were compared after treatment is completed, then analysis of prognostic factors was analyzed. Results Excellence rate of dual plate fixation group was significantly higher than the Y- shaped plate fixation group （ P 〈 0.05 ） , and its fracture healing time and complication rate was significantly lower than the Y-shaped plate fixation group （ P 〈 0.05 ）. Associated injuries, the type of fracture,internal fixation, and postoperative functional exercise were independent influential factors. Conclusion For patients with C-type distal humerus fracture, dual plate fixation of olecranon osteotomy approach has in- deed efficacy, and they should be given early postoperative functional exercise to promote the functional recovery of the elbow.