改良后侧入路治疗肱骨髁间骨折的疗效分析

Efficacy Analysis of Modified Posterior Approach for Treatment of Humeral Condylar Fractures

目的比较评价后侧纵行劈开肱三头肌、后侧改良两种不同手术入路治疗肱骨髁间骨折的优缺点。方法回顾性分析2010年1月至2012年10月在我院行肱骨髁间骨折手术治疗的82例患者(全部为单处骨折)的临床资料,其中后侧三角肌劈开入路47例,经改良后侧入路35例。结果通过分析比较两组患者术后肘关节的上肢、肩、手功能障碍(disabilities of the arm,shoulder and hand,DASH)评分,Mayo肘关节功能评价和Knirk评分等,两组患者肘关节的功能差异无统计学意义(P>0.05)。结论采用改良后侧手术入路行肱骨远端骨折的手术治疗安全有效,效果等同于后侧三角肌劈开入路,但是显露范围较后者较广泛。

Objective The present study aims to evaluate the advantages and disadvantages of posterior longitudinal triceps-splitting approach and modified posterior approach for treatment of humeral condylar fractures. Methods A retrospective analysis was performed in the clinical data of 82 cases of patients who were admitted in our hospital from January 2010 to October 2012 and underwent surgeries for treatment of distal humerus fractures （single fractures）. Among them, 47 cases of patients underwent posterior triceps-splitting approach, while 35 cases underwent modified posterior approach. Results The postoperative abilities of patients disabilities of the arm, shoulder and hand （DASH） score, Mayo elbow performance scoreand Knirk score were compared between two groups, without statistically significant difference （P〉0.05）. Conclusion The modified posterior approach was safe and effective for treatment of distal humerus fractures. Its effect was equivalent to the posterior triceps-splitting approach, but it could expose a wider range.