双解剖锁定板治疗C型肱骨髁间骨折疗效分析

Early Term Observation of Humeral Intercondylar Fractures Treated by Open Reduction and Double Locking and Anatomical Plates

目的：观察切开复位双解剖锁定板治疗 C 型肱骨髁间粉碎性骨折的早期疗效。方法对15例采用切开复位双解剖锁定板治疗的肱骨髁间粉碎性骨折患者进行回顾性研究，其中男10例，女5例；年龄24~67岁，平均40.8岁。致伤原因为跌伤9例，交通事故伤4例，高处坠落伤2例。合并尺神经损伤1例。左侧9例，右侧6例，均为闭合性损伤。按 AO/ ASIF 分类，C1型3例，C2型8例，C3型4例。所有病例均行后路肱三头肌舌形肌瓣入路双解剖锁定板固定，同组医生手术，术后早期活动，定期复查。术后2周、6周、10周、14周、22周按 Cassebaum 肘关节功能评分系统评定术后肘关节功能。术后1年、4年用 Mayo 肘关节功能评分对结果进行评价。结果随访12~48个月，平均19.4个月。术后22周 Cassebaum 评分，优9例，良5例，可1例，优良率为86％。Mayo 评分为60~100分，均分90.8分，优10例，良4例，可1例，优良率为93.3％。结论切开复位双解剖锁定板治疗 C 型肱骨髁间粉碎性骨折早期疗效满意。

Objective To analysis early results of humeral intercondylar fractures treated with open reduction and internal fixa_tion with double AO locking and anatomical plates. Methods Early term follow_up data of 15 cases suffered from humeral in_tercondyler fractures treated by open reduction and internal fixation with double AO locking and anatomical plates was reviewed retrospectively. There were 10 males and 5 females. The mean age was 40. 8 years with a range of 24 to 67 years. There were 9 left elbow fractures and 6 right. According to AO/ ASIF classification,there were 3 type C1 cases,8 type C2 cases,and 4 type C3 cases. All were close fractures. Traditional Posterior operating approach of elbow and internal fixation by standard method of AO double plates or LCP were performed in all cases. The patients began the active training of elbow joint as soon as possible postoperative. Results These patients were followed up from 12 to 48 months with the average of 19. 4 months. According to the Cassebaum scoring system,there were excellent in 9 cases,good in 5 cases,and fair in 1 case,and the excellent_good rate was 86% . The results were 60 ~ 100 with Mayo scores with an average of 90. 8. Eight cases were excellent,six cases were good and one cases were fair. The excellent and good rate was 93. 3% . Conclusion The early term results of humeral intercondylar fractures treated by open reduction and internal fixation with double plates are satisfactory.