双钢板治疗肱骨髁间粉碎性骨折的疗效

The curative effect of double plates in the treatment of humeral intercondylar comminuted fractures

目的探讨双钢板治疗肱骨髁间粉碎性骨折的临床效果。方法对40例肱骨髁间粉碎性骨折患者进行手术治疗,根据术前X线及三维CT检查对骨折进行分型。均采用肘后纵向S形切口,24例C2型中采用肱三头肌纵向劈开入路15例、肱三头肌两侧入路9例;16例C3型中采用肱三头肌纵向劈开入路10例、尺骨鹰嘴截骨入路6例。均使用双侧锁定钢板内固定。结果 40例均获得随访,时间10~48(12±5.1)个月。骨折愈合时间3~5(3.5±0.5)个月,按Cassbaum肘关节功能评分系统与患者的主观症状相结合作为最终功能评分对手术效果进行评价:优18例,良16例,可5例,差1例,优良率85.0%。结论双钢板治疗肱骨髁间粉碎性骨折,术前根据X线和CT检查充分了解骨折分型和粉碎程度,根据分型和影像学改变确定手术方案和正确选择手术入路及双钢板,合理指导功能锻炼,可取得良好疗效。

Objective To explore the effects of double plates in the treatment of humeral intercondylar comminuted fractures. Methods Forty cases with humeral intercondylar comminuted fractures were conducted with surgical treatment,according to the preoperative X-ray and three-dimensional CT examination,all cases were carried out on the fracture types. Vertical S-shape incision behind elbow was adopted. C2 type used in 24 cases of triceps longitudinal split into approach 15 cases,triceps on both sides in the 9 cases; C3 type used in 16 cases of triceps longitudinal split into 10 cases,ulna olecranon 6 cases bone cutting into the approach. All cases were used the double side locking plates internal fixation. Results 40 cases were followed up for 10 - 48（ 12 ± 5. 1） months. Fracture healing time was 3 - 5（ 3. 5 ± 0. 5） months,according to Cassbaum elbow function scoring system combined with the subjective symptoms of patients as the final functional score to evaluate the surgical effect： excellent 18 cases,good 16 cases,fair 5 cases,poor 1 case,excellent-good rate was 85. 0%. Conclusions Double plates in the treatment of humeral condyle comminuted fracture,according to the X-ray and CT examination,fully understand fracture classification and degree of crushing,operation scheme determined according to the classification and the imaging changes and correct selection of surgical approach and double plates,reasonable to guide function exercise,can achieve good curative effect.