前外侧入路微创锁定加压钢板治疗肱骨干骨折疗效观察

Effect of locking compression plate(LCP) in the treatment of middle distal humeral shaft fracture

目的 肱骨干骨折是临床最常见的骨折之一,随着现代医学的发展,内固定手术已成为主要治疗手段。观察锁定加压钢板（LCP）治疗肱骨干中、下段骨折的临床疗效。方法 自2011年4月—2013年4月,使用锁定加压钢板治疗肱骨干中、下段骨折27例,其中男性16例、女性11例,根据AO分型：A型7例,B型15例,C型5例。待局部消肿后选择3~7 d内（平均5 d）进行手术治疗。取上臂前外侧纵向切口,沿肱二头肌与肱桡肌间隙进入,沿肱肌肌肉外侧约1/4处纵向劈开并显露骨折断端复位内固定手术治疗。结果 术后均获随访,随访时间9~18个月,平均12个月。X线检查骨折全部愈合,愈合时间2~8个月,平均3.5个月。根据Mayo标准进行肘关节功能评分,优23例,良4例,优良率100%。肩关节功能均良好。结论 锁定加压钢板前外侧入路内固定治疗肱骨干中、下段骨折固定牢靠,组织创伤小,愈合率高,手术操作难度相对低,疗效确切,很适合基层医院。

Objective Humeral shaft fracture is one of the most common clinical fractures, with the development of modern medicine, internal fixation surgery has become a main treatment. The clinical effect of locking compression plate （LCP） in the treatment of middle and lower segment to shaft of humeral fracture is satisfying. Methods Form April 2011 to April 2013, there were 27 cases of the use of locking compression plate in the treatment of middle, lower segment fracture, including 16 cases of male and 11 cases of female, according to the AO type：type A 7 cases,type B 15cases, type C 5 cases. To operatei in 3 - 7 days （ an average of 5 days） after the local swelling-reduction. Cut anterolateraUy and longitudinally in upper arm , enter between brachial biceps and brachioradialis, carry out interal fixation surgery where fracture occurs, split longitudinally about 1/4 of the lateral brachial muscles. Results Postoperative follow-up is, peri- od ：9 - 18 months, an average of 12 months. X-ray test all the fractures were healed, the healing time ：2 - 8 months, an average of 3.5 months. According to the Mayo standard elbow function score,23 cases were good, 4 cases were benign, the good rate was 100%. Shoulder joint functions are good. Conclusion The anterolateral approach to locking compres- sion plate fixation in the treatment of middle, lower segment fracture is reliable with less trauma and high healing rate, the operation difficulty is relatively low, and has definite effect, thus it is very suitable for primary hospitals.