解剖型平行双钢板和垂直双钢板治疗肱骨髁间骨折

Parallel versus perpendicular anatomic double plating for intercondylar humerus fractures

目的对采用新型解剖型设计的垂直双钢板与平行双钢板治疗肱骨髁问骨折进行回顾性比较研究，评价两种固定方式的临床效果。方法完整随访45例采用解剖锁定板治疗的肱骨髁间骨折患者，其中垂直双钢板固定（垂直组）26例，平行双钢板固定（平行组）19例。最终随访时采用Mayo肘关节评分（Mayo elbow performance score,MEPS）对患者进行评价，并记录所有并发症。结果所有患者肱骨髁问骨折均愈合，患侧肘关节均没有疼痛。患侧肘关节屈伸活动度平行组为（100±21）°，垂直组为（99±34）°。患侧前臂旋转活动度平行组为（164±12）°，垂直组为（171±16）°。平行组MEPS评分为（91±6）分，优良率为100％；垂直组MEPS评分为（914-10）分，优良率为92％（P〉0．05）。结论解剖型平行双钢板和垂直双钢板治疗肱骨髁问骨折均有很好的临床效果。可根据骨折的形态、患者的个体情况等选择适合的内固定方式。

Objective To retrospectively compare the clinical effect of anatomically designed perpendicular and parallel double plates in fixation of intercondylar humerus fractures. Methods A complete follow-up was made on 45 patients treated with anatomic locking plates for intercondylar humerus fractures. Among them, 26 underwent perpendicular double plate fixation （perpendicular group） and 19 parallel double plate fixation （parallel group）. Mayo elbow performance score （MEPS）was performed at the last follow-up. All postoperative complications were documented as well. Results All fractures were healed without joint pain in the elbow. Arc of elbow flexion and extension, arc of forearm rotation, MEPS and rate of excellent/good outcomes between parallel and perpendicular groups were （ 100 ± 21 ）°vs （99±34）°, （164±12）° vs （171±16）°, （91 ±6） points vs （91±10） points, 100% vs92%, respectively （P〉 0. 05 ）. Conclusions Both fixation methods are effective in treatment of intercondylar humerus fractures. Additionally, the surgeons can make a choice about fixation methods based on fracture pattern and individual condition of the patients.