经尺骨鹰嘴截骨与经肱三头肌舌形瓣入路治疗成人AO-C型肱骨骨折的疗效比较

Comparison of the efficacy of olecranon osteotomy and trochanter lingual petal approach in treatment of adult AO-C humerus fractures

目的比较经尺骨鹰嘴截骨与经肱三头肌舌形瓣入路治疗成人AO-C型肱骨骨折的临床疗效。方法成人AO-C型肱骨骨折病人70例,使用随机数字表法分为两组,每组各35例,Ⅰ组采用经尺骨鹰嘴截骨入路内固定术,Ⅱ组采用经肱三头肌舌形瓣入路内固定术。比较两组的术后并发症发生率、肘关节功能恢复情况等。结果两组病人的手术时间、术中出血量、骨折愈合时间、住院时间比较无明显差异(P> 0. 05)。术后1年,Ⅰ组患者的肘关节功能恢复优良率为88. 57%,显著高于Ⅱ组的60. 00%(P <0. 05)。Ⅰ组的并发症总发生率为17. 14%,Ⅱ组为20. 00%,组间比较无明显差异(P> 0. 05)。结论两种入路方式治疗AO-C型肱骨骨折均能获得满意的效果,与经肱三头肌舌形瓣入路比较,经尺骨鹰嘴截骨入路治疗成人AO-C型肱骨骨折的肘关节功能恢复效果更好。

Objective To compare the clinical efficacy of olecranon osteotomy and trochanter lingual petal approach in treatment of adult AO-C humerus fractures. Methods 70 cases of adult AO-C humerus fractures patients were divided into two groups by random number table method( n = 35). GroupⅠ was treated with olecranon osteotomy approach fixation,and group Ⅱ was treated with triceps by passage into the tongue-shaped flap fixation. Then compared the incidence of postoperative complications,elbow joint function recovery situation and so on. Results There was no significant difference between the two groups in operation time,blood loss,fracture healing time and hospitalization time( P > 0. 05). After operation 1 year,the elbow joint function recovery rate was 88. 57% in group Ⅰ,which was significantly higher than 60. 00% in group Ⅱ( P < 0. 05). The total complication rate was 17. 14% in group Ⅰ and20. 00% in group Ⅱ,there was no significant difference between the two groups( P > 0. 05). Conclusion The two approaches can be used to treat AO-C humeral fractures with satisfactory results. However,the elbow joint function of AO-C humerus fracture treated by olecranon osteotomy approach is better.