全肘关节置换治疗老年肱骨远端骨折的疗效评估

Evaluation of total elbow arthroplasty in treatment of distal humeral fracture in the elderly

目的 评估全肘关节置换治疗老年肱骨远端骨折的远期疗效.方法 回顾性分析2003年12月至2009年1 1月北京积水潭医院创伤骨科因肱骨远端骨折行Coonrad-Morry人工肘假体置换术患者24例.术后通过拍摄X线片、临床评估规则随访,通过Mayo肘关节评分（MEPS）评估末次随访时肘关节功能.结果 共有20例患者获得完整随访,随访时间（7.6±1.7）年,视觉疼痛模拟评分（VAS）平均分为（0.8±1.0）分,平均伸直（25±17）°,平均屈曲（112±16）°,MEPS评分88.5分,优7例,良8例,中1例,优良率93.8％.2例患者出现严重异位骨化,3例患者出现尺神经炎,其中2例为一过性神经炎.1例浅表感染,1例出现肱骨侧假体松动,但未行翻修手术治疗.结论 全肘关节置换手术可以成功的用来治疗老年肱骨远端骨折,并保持长期疗效。

Objective To evaluate the efficacy of total elbow arthroplasty in treatment of distal humeral fracture in the elderly.Methods A total of 24 elderly patients who were diagnosed of distal humeral fracture and received Coorad-Morry prosthesis arthroplasty were retrospectively selected and analyzed from Beijing Jishuitan Hospital from 2003 to 2009.X ray examination of elbow joint and clinical evaluation were conducted in the follow-up;Mayo Elbow Performance Score （MEPS） was used in the last follow-up to evaluate patients＆#39; elbow function.Results A total of 20 patients with intact follow-up information were included in the final analysis,with mean follow-up length 92 months （65-136）,mean VAS score 0.8 （0-2）,extension degree of elbow 25 （0-60） °,flexion degree 112 （80-135） °;Mean MEPS was 88.5,with 7 excellent,8 good,and 1 fair.Two patients had severe heterotopic ossification,3 patients had ulnar neuropathy,2 of which were temporary.One patient had superficial infection,and 1 had aseptic loosening in the humeral part,but did not receive revision surgery.Conclusion Total elbow arthroplasty can successfully treat distal humeral fracture in the elderly and achieve satisfactory result which can last for a long time.