三种内固定方法治疗肱骨髁间粉碎性骨折的疗效比较

The Comparative Effectiveness of Three Methods of Internal Fixation in Treatment of Humeral Intercondylar Comminuted Fracture

目的:探讨三种内固定方法治疗肱骨髁间粉碎性骨折的临床疗效。方法:选取本院2009年5月-2013年4月收治的诊断为肱骨髁间粉碎性骨折的患者90例,将患者随机平均分配为A组、B组和C组,其中A组采用单钢板螺钉进行固定,B组采用"Y"形钢板进行固定,C组采用双钢板进行固定,比较三组内固定成功率、肘关节功能和临床并发症等。结果:肘关节功能评定结果显示B组和C组术后肘关节功能的恢复情况明显优于A组,差异具有统计学意义(P<0.05);三组患者治疗结果显示,B、C两组的内固定成功率远优于A组患者,差异具有统计学意义(P<0.05)。术后患者均未出现切口深部感染和局部皮肤坏死等恶性并发症。结论:临床上对肱骨髁间粉碎性骨折患者进行治疗,建议首先考虑采用双钢板治疗或"Y"形钢板内固定法,能促进患者术后肘关节功能恢复,改善治疗效果,值得在临床上推广使用。

Objective：To discuss the clinical curative effect of three methods of internal fixation in treatment of humeral intercondylar comminuted fracture.Method：90 cases of humeral intercondylar comminuted fracture from May 2009 to April 2013 in our hospital were selected and randomly divided into group A,group B and group C. Group A were treated with single plate screw fixation,group B were treated with＂Y＂shaped steel plate fixation,group C were treated with double plate fixation.Success rate of internal fixation,elbow function and clinical complications of three groups were compared. Result：Group B and group C patients’elbow function were significantly better than that of group A,the difference had significant（P〈0.05）;B and C groups’success rate of fixation were much better than that of group A,the difference had significant（P〈0.05）.Postoperative patient had not incision deep infection and malignant complications of local skin necrosis. Conclusion：In the treatment of humeral intercondylar comminuted fracture,double plate or＂Y＂shaped steel plate internal fixation method can promote patients recovery of elbow joint function and improve the therapeutic effect,it is worth popularizing in clinical use.