腓骨远端解剖钢板治疗成人肱骨外髁粉碎性骨折

The treatment of adult humeral lateral condyle comminuted fracture using anatomical plate of distal fibula

目的探索应用腓骨远端解剖钢板治疗成人肱骨外髁粉碎性骨折的临床效果。方法 2012年6月-2015年3月,应用腓骨远端解剖钢板治疗成人肱骨外髁粉碎性骨折12例,其中男7例,女5例,年龄22-59岁（平均38岁）,均为闭合性骨折。12例均采用肱骨远端外侧入路、对侧腓骨远端解剖钢板放置于肱骨远端后外侧。对手术时间、术中出血量、术后功能锻炼时间、术后3月时肘关节功能恢复情况、骨折愈合情况、有无钢板断裂等方面进行回顾性分析、总结。结果平均手术时间62分钟（50-76分钟）,术中出血量20m L（10-45m L）,其中1例因脂肪液化伤口愈合不良,经换药2周后伤口顺利愈合,余患者切口均Ⅰ期愈合,无切口感染。术后11例患者获得随访,随访时间6-21个月,平均14个月。术后3月时肘关节功能根据Cassebaum评分系统：优良率为91%。全部患者骨性愈合,未见内固定物松动、断裂等并发症发生。结论腓骨远端解剖钢板治疗成人肱骨外髁粉碎性骨折能达到坚强固定、早期功能锻炼的目的,肘关节功能恢复良好,并发症发生率低。

Objective To explore the clinical efficacy of the treatment of adult humeral lateral condyle comminuted fracture using anatomical plate of distal fibula. Methods From June 2012 to March 2015, anatomical plate of distal fibula were used in 12 cases, adult humeral lateral condyle comminuted fracture, including 7 males and 5 females, from 22 to59 years（mean 38 years）. All cases were closed fractures. Lateral approach of the distal humerus were used in 12 cases, and the contralateral distal fibula anatomical plates were placed in the posterolateral side of distal humerus. To analyze and summarize from the operative time, blood loss, postoperative functional exercise time, postoperative elbow function recovery in 3 months, fracture healing, with or without plate fracture, and so on. Results The operation time was 50 to76 minutes, with an average of 62 minutes; blood loss was 10 to 45 m L, with an average of 20 m L. No postoperative wound infection. 11 cases were followed up from 6 to 21 months, with an average of 14 months. Elbow function after 3months of operation with Cassebaum scoring system： excellent and good rate was 91%. All fratures healed, with no internal fixation loosening, fracture and other complications. Conclusion The treatment of adult humeral lateral condyle comminuted fracture using anatomical plate of distal can achieve strong fixation, do exercise earlier, with good elbow function and low complication rate.