改良肱骨后入路治疗肱骨中下段骨折

Treatment of the mid and distal segment humeral fractures through modified posterior approach

目的:总结应用改良肱骨后入路治疗肱骨中下段骨折的临床结果。方法:2006年1月至2010年12月,对26例肱骨中下段骨折患者应用改良肱骨后入路行内固定治疗,男17例,女9例;年龄24~50岁,平均(37.1±1.5)岁。肱骨骨折后至手术时间8 h^6 d,平均(3.3±0.6)d。肘关节功能按Morrey和Bryan提出的评定标准评定疗效。结果:术后未发生与手术相关的并发症,无神经损伤与伤口感染。术后随访22~48个月,平均(30.1±1.6)个月。肱骨骨折全部愈合。Morrey-Bryan肘关节功评定结果,优19例,平均(94.6±1.8)分;良7例,平均(86.5±1.2)分。结论:改良肱骨后入路避免了对肱三头肌的损伤,改善了术后肱三头肌的功能,很适用于肱骨中下段骨折的治疗。

Objective：To summarize clinical result of the modified posterior approach for the treatment of the mid and distal segment humeral fractures. Methods：Between January 2006 and December 2010,26 patients with the mid and distal segment humeral fractures were treated with the open reduction and plate fixation by the modified posterior approach including17 males and 9 females with an average of（37.1±1.5） years old ranging from 24 to 50 years old. The time from humeral fractures to operation were from 8 hours to 6 days with an average of（3.3±0.6） d. The elbow function were assessed by MorreyBryan. Results：There was no procedure related complications occurred. No neurologic injury and wound infection after operation occurred. All patients were followed up from 22 to 48 months with an average of（30.1±1.6） months. The humeral fractures were confirmed healing. The clinical results of Morrey and Bryan were excellent in 19 cases（94.6±1.8）,good in 7 cases（86.5±1.2）. Conclusion：The modified posterior approach avoided injury of triceps muscle and improved postoperative triceps function. The technique may be particularly useful in the treatment of the mid and distal segment humeral fractures.