肱骨远端解剖特点及双钢板治疗粉碎性骨折临床分析

Clinical analysis of comminuted fractures of the distal humerus treated with dual-plate based on anatomical characteristics

目的结合肱骨远端解剖特点，分析双钢板治疗粉碎性骨折的合理性及其疗效。方法对16例肱骨远端粉碎性骨折患者（按AO分类：C2．1型6例，C2．2型3例，C3．1型5例，C3．2型2例），采用鹰嘴截骨入路切开复位，双钢板内固定术。结果全部患者获得随访，时间为15．25个月，平均18．5个月。按Cassebaum肘关节功能评价标准进行评估：优5例，良8例，一般3例；优良率为81．3％。结论双钢板固定肱骨远端粉碎性骨折内外侧柱，稳定性好，肘关节功能恢复满意。

Objective To evaluate the rationale and clinical outcomes of dual-plate fixation for treatment of comminuted fractures of the distal humerus based on its anatomical characteristics. Methods Sixteen cases of comminuted fractures of the distal humerus were treated with dual-plate fixation via an olecranonectomy approach. According to AO classification there were 6 cases of type C2.1 fractures, 3 cases of type C2.2, 5 cases of type C3.1 and 2 cases of type C3.2. Results All cases were follow-up for 15 to 25 months （average 18.5 months）. The results were assessed using the Cassebaum scoring system and graded as excellent in 5 cases, good in 8 cases, and fair in 3 cases. The satisfactory rate of elbow function was 81.3 %. Conclusion Dualplate fixation can reliably fix the medial and lateral columns of the distal humerus to maintain stability and restore satisfactory elbow function.