延期切开复位内固定选择性植骨治疗C3型成人肱骨髁间骨折

Delayed open reduction and internal fixation and selective bone grafting in the treatment of type C3 adult humerus condyle fracture

目的探讨延期切开复位内固定并选择性植骨治疗C3型成人肱骨髁间骨折临床效果。方法对28例C3型成人肱骨髁间骨折患者采用延期切开复位内固定选择性植骨治疗,9例经舌形瓣入路,5例经肱三头肌内外侧联合切口入路,14例经尺骨鹰嘴截骨入路。10例骨折端有明显骨缺损,5例取自体髂骨植骨,5例选用同种异体骨植骨。术后非持重状态下渐进性早期肘关节活动练习。结果所有患者均获随访,时间18~76（36.6±2.06）个月。骨折均愈合。肘关节功能评价按HSS评分标准进行功能评定：优13例,良12例,可2例,差1例。2例可及1例差者分别为舌形瓣入路及肱三头肌内外侧联合入路。结论采用延期切开复位内固定选择性植骨治疗C3型成人肱骨髁间骨折疗效满意。

Objective To investigate the clinical efficacy of open reduction and internal fixation and selective bone grafting in the treatment of AO type C3 adult humerus condyle fracture. Methods 28 cases with type C3 adult humerus condyle fracture were treated by open reduction and internal fixation and selective graft after improvement of soft tissue conditions. 9 cases were used by the ligulae valve into the road,triceps inside and outside the joint incision approach in 5 cases,14 cases by ulna olecranon osteotomy. 10 cases of fracture had obvious bone defect,and 5patients got autogenous iliac bone graft,5 cases got allogenic bone graft. Postoperative early elbow movement was not overweight condition progressive practice. Results All cases were followed up for 18 ~ 76（ 36. 6 ± 2. 06） months.Fractures were healed. Elbow function evaluation according to HSS scoring criteria for functional assessment,excellent in 13 cases,good in 12 cases,fair in 2 cases,poor in 1. 2 cases of fair and poor in 1 case could be respectively used approach. Conclusions The open reduction and internal fixation and selective bone grafting can achieve good clinical efficacy in the treatment of type C3 adult humerus condyle fracture.