肱骨远端粉碎性骨折解剖钢板与锁定钢板内固定的疗效分析

Clinical effect of distal humerus comminuted fracture with anatomical plate and locking plate internal fixation

目的：探究分析肱骨远端粉碎性骨折解剖钢板与锁定钢板内固定的疗效。方法：选取2007年6月～2012年6月在我院就诊的46例肱骨远端粉碎性骨折患者，每组23例。采用随机的方法将其分为对照组和观察组，观察组患者采用解剖钢板内固定治疗，对照组患者采用锁定钢板内固定治疗，观察比较2组患者的治疗效果。结果：46例患者术后均获得随访，随访时间为6～18个月，平均随访14个月，骨折全部愈合，平均愈合时间为4．2个月。按Cassebaum肘关节功能评定标准，观察组优17例，良4例，可2例，优良率为91．3％；对照组优15例，良5例，可3例，优良率为87％。结论：解剖钢板治疗肱骨远端粉碎性骨折有利于骨折复位，可以给骨骼以牢固、稳定的支撑，患者可早期功能锻炼；锁定钢板内固定更适用于老年骨质疏松者，骨折粉碎程度重或有髁间骨质缺损的情况。因此在治疗时，应根据患者的情况来选定具体的治疗方法。

Objective： To discuss the clinical effect of the distal humerus comminuted fracture with anatomical plate and locking plate internal fixation. Methods：From 2007 June to 2012 June in our hospital 46 cases of distal humerus comminuted fracture patients,23 patients in each group, were randomly divided into the observation group and the control group, the observation group were treated with anatomical plate fixation, the control group was treated with locking plate internal fixation, treatment effects were compared between the two groups of patients. Results： 46 patients were followed up, the duration of follow -up was 6 to 18 months,average 14 months follow -up, all fractures healed,the average healing time of 4.2 months. According to Cassebaum elbow function evaluation standard, the observation group 17 cases of excellent, good in 4 cases,2 cases, the excellent and good rate was 91.3 % ; the control group 15 cases of excellent, good in 5 cases,3 cases,the excellent and good rate was 87%. Conclusion： Anatomic plate in treatment of comminuted distal humeral fracture for fracture reduction, could give the bones to firm, stable support, patients could be early functional exercise; locking plate fixation might be more suitable for the elderly osteoporosis, fracture comminution heavy or intercondylar bone defect. Therefore, in the treatment, should be to select a specific treatment according to the patient＇ s condition.