经肱三头肌腱两侧入路行肱骨截骨矫形治疗肘关节复杂畸形的临床分析

Clinical Analysis of Humeral Osteotomy by Bi-paratricipital Approach Through Triceps Tendon in Treatment of Elbow Complex Deformity

目的探讨经肱三头肌腱两侧入路加双钢板固定行肱骨髁上截骨矫形术治疗肘关节复杂畸形的疗效。方法 2006年6月—2012年12月收治的13例肱骨髁间和（或）髁上粉碎性骨折夹板外固定后出现肘内翻畸形、屈肘畸形的病例,采用经肱三头肌腱两侧入路、肱骨髁上楔形截骨矫形、双钢板内固定技术治疗。结果术后11例获随访,随访时间6～24个月,术后平均9个月获骨性愈合,术后评定结果：优9例,良2例,可1例,差1例。结论经肱三头肌两侧入路截骨矫形加双钢板固定术治疗肘关节复杂畸形,术后骨折断端愈合坚固,功能恢复良好。

Objective To investigate the effect of humeral osteotomy by bi-paratricipital approach and double plate fixation through triceps tendon in treatment of elbow complex deformity. Methods A total of 13 patients with cubi-tus varus deformity or elbow flexion deformity after splint external fixation on humeral condyle and （ or） between condyles for comminuted fractures, were treated by supracondylar wedge-shaped osteotomy and two plates of internal fixation through the bi-paratricipital approach through triceps tendon. Results Eleven patients were followed up, and the mean follow-up time was 6-24 months. The osseous healing was found at postoperative average 9 months, and the postoperative evaluation showed that 9 patients with best, 2 patients with good, 1 patient with common and 1 patient with poor result. Conclusion Humeral osteotomy by bi-paratricipital approach and double plate fixation through triceps tendon in treat-ment of elbow complex deformity may achieve strong healing and good functional recovery.