改良前外侧入路治疗肱骨中下段骨折疗效分析

Improved anterolateral approach in the treatment of middle distal humeral fractures

目的探讨改良前外侧入路钢板内固定治疗肱骨中下段骨折的临床疗效。方法将2012年1月至2015年2月收治的肱骨中下段骨折患者69例随机分为两组:改良前外侧入路组(改良组)38例,传统前外侧入路组(传统组)31例。两组患者均采用钢板内固定治疗。结果随访半年以上。改良组手术时间[(55.0±5.2)min]少于传统组[(83.0±5.5)min],改良组医源性桡神经损伤0例,少于传统组3例(9.7%),差异有统计学意义(P<0.05);两组患者骨折愈合时间、肘关节功能比较,差异无统计学意义(P>0.05)。结论改良前外侧入路钢板内固定治疗肱骨中下段骨折手术可清晰显露视野,简化钢板放置操作,缩短手术时间;且无需常规游离显露桡神经,可降低医源性桡神经损伤的风险。

Objective To explore the clinical efficacy of intemal fixation with plate by improved anterolateral approach of upper arm in the treatment of middle distal humeral fractures. Methods A retrospective study was performed on 69 patients with middle distal humeral fractures who were admitted in No. 180 Hospital of PLA from January 2012 to February 2015. Patients were divided into the improved anterolateral approach group（ treatment group,n = 38） and the conventional anterolateral approach group（ control group,n =31）. Both of the two groups of patients were treated with plate internal fixation for humeral fractures. Results The patients were followed up for 6 months. The average operation time in the treatment group[（55. 0 ± 5. 2） minutes]were shorter than that in the control group[（83. 0 ± 5. 5） minutes],and the iatrogenic radial nerve injury in the treatment group（0 case） was significantly lower than that in the control group（3 cases）（ P〈0. 05）. The fracture healing time and the function of elbow joint were not statistically significant between the two groups（ P〉0. 05）. Conclusion The improvement of the internal fixation of the anterior lateral approach of the treatment of fractures of the treatment of fractures of the middle distal humeral has clearly show vision,easy to put plate,and the operation time is shortened. The radial nerve is not required for routine free exposure,which can reduce the risk of iatrogenic radial nerve injury,worthy of clinical promotion.