尺骨鹰嘴截骨入路“Y”形锁定钢板内固定治疗肱骨髁间骨折

The fixation of humeral condylar fracture by olecranon osteotomy and "Y"-shaped locking plate

目的探讨尺骨鹰嘴截骨入路“Y”形锁定钢板内固定治疗肱骨髁间骨折的手术方法及临床疗效。方法对2009年12月至2011年12月30例的成年人“C”型肱骨髁间骨折，均选用尺骨鹰嘴截骨入路、“Y”形锁定钢板内固定治疗。其中男性18例，女性12例，年龄18～50岁，平均（38．6-7．8）岁。采用Mayo标准进行肘关节功能疗效评定。结果对本组患者随访12～18个月，全部获得随访，肱骨髁间骨折及尺骨鹰嘴截骨处均骨I生愈合，骨折愈合平均时间为（3．0±．6）月，根据Mayo评分为50～100分，平均87分，优24例，良1例，可3例，差2例，优良率为83．3％。结论尺骨鹰嘴截骨入路“Y”形锁定钢板内固定治疗肱骨髁间骨折具有暴露术野清晰，内固定牢靠，可早期进行肘关节功能锻炼等优点，临床疗效满意。

Objective To investigate the fixation of humeral fractures by olecranon osteotomy and ＂Y＂-shaped locking plate as well as the clinical efficacy of this approach. Methods Form December 2009 to December 2011, 30 cases of adult type ＂C＂ humeral condylar fracture, were selected for treatment by olecranon osteotomy and ＂Y＂-shaped locking plate fixation. The patients included 18 males and 12 females, whose age ranged from 18 to 50 years, with average of （38.6±7.8） years old. Mayo elbow performance scoring was used for post-operative efficacy evaluation. Results The patients were followed up for 12 to 18 months. Bone healing, taking an average of （3.0 ±0.6） months, was achieved in humerus fractures and olecranon osteotomy. The efficacy evaluation scored 50 to 100 by Myo performance scoring system, with an average of 87 points, The efficacy was excellent in 24 cases, good in 1 case, mediocre in 3 cases and poor in 2 eases. The good rate was 83.3%. Conclusion The fixation of humeral condylar fracture by oleeranon osteotomy and ＂Y＂-shaped locking plate has such advantages as a clear operative field, internal rigid fixation, and enabling for early functional elbow exercises. The clinical results were satisfactory.