双钢板内固定治疗肱骨髁间骨折的疗效观察

Clinical observation of Double plate internal fixation for humeral intercondylar fracture

目的探讨尺骨鹰嘴截骨入路双钢板治疗肱骨髁间骨折的临床疗效。方法总结41例实施尺骨鹰嘴截骨入路双钢板治疗肱骨髁间骨折患者的临床经验,并分析治疗效果。结果术后肘关节Gassebaum评分,优33例,良5例,可2例,差1例,总优秀率达到80.5%;40例患者的伤口一期愈合,1例患者行伤口负压引流后通过植皮二期愈合;39例患者术后3～6个月尺神经功能恢复正常,2例患者存在有术后尺侧神经支配区域麻痹,术后2年恢复正常;出院时患者疼痛VAS评分0～4分,平均(1.2±0.1)分,未出现关节僵硬。结论肱骨髁间骨折使用尺骨鹰嘴截骨入路行双钢板固定有效避免了对肱三头肌的损伤,术后效果确切,术后恢复快,是一种值得临床推广的方法。

Objective To investigate the effect of double plate internal fixation for humeral intercondylar fracture. Methods The clinical experience of 41 cases with olecranon osteotomy approach by double plate for humeral inter- condylar fractures were choosed, and then the therapeutic effect were analyzed. Results Postoperative elbow Gasse- baum score of excellent were 33 cases, good were 5 cases, common were 2 cases, poor was 1 case, the total excellent rate was 80.5%; wound healing were 40 cases, 1 patient with negative pressure wound drainage after skin grafting healing; ulnar nerve function returned to normal after 3 to 6 months were 39 cases, postoperative ulnar nerve palsy af- ter operation was 2 cases and it restored to normal after 2 years; patients pain score （VAS） was 0-4, averaged was （1.2±0.1）, it had no joint stiffness. Conclusion The olecranon osteotomy approach with double plate fixation for inter- condylar fracture of humerus is effectively and it avoids triceps injury and effect is precise at the postoperativetime, patients has rapid postoperative recovery, so it is a worthv of clinical application methods.