Herbert钉治疗肱骨小头冠状面骨折的临床分析

Coronal plane fractures of capitellum treated with open reduction internal fixation using Herbert screws

目的：探讨切开复位Herbert钉内固定治疗肱骨小头冠状面骨折的疗效。方法采用切开复位Herbert钉内固定治疗肱骨小头冠状面骨折11例,男6例,女5例；年龄23~56岁。 Bryan-Morrey分型：Ⅰ型5例,Ⅳ型6例。结果随访12~25个月,骨折愈合时间（14±3）周。骨折均愈合,无迟发性尺神经炎、易位骨化、内固定失败、肱骨小头缺血性坏死等并发症发生。改良Cassebaum评分系统评定疗效：优5例,良4例,可2例,差0例。优良率81.8%。结论肱骨小头冠状面骨折切开复位内固定可获得满意的效果, Herbert钉能够提供可靠的稳定固定。

Objective To retrospectively evaluate the clinical outcomes of 11 patients with coronal plane fractures of capitellum treated with Herbert screws Method Eleven patients were identified （6 men, 5 women） with an average age of 36. 2 years and an average follow-up of 16 months. Fractures were classified according to the Bryan-Morrey classification as 5 type-Ⅰ injuries and 6 type-Ⅳ injuries. The functional results were evaluated by the Cassebaum scale. Result All patients, with the exception of 2, had good to excellent functional results by the Cassebaum scale （81. 8%）. There were no subsequent development of avascular necrosis. No significant negative complications occurred. There were no heterotopic ossification around elbow. Conclusion Herbert screw fixation allows for stable fix-ation in patients with large coronal shear fractures of the distal humerus without posterior comminution.