经肱三头肌内外侧入路内固定治疗肱骨髁间骨折的疗效观察

The clinical observation of after bilateral triceps approach fixation in the treatment of humeral intercondylar fracture

目的观察经肱三头肌内外侧入路内固定治疗肱骨髁间骨折的疗效。方法60例肱骨髁间骨折患者根据手术入路将上述患者分为尺骨鹰嘴截骨入路组（A组，n=30）和肱三头肌内外侧入路内固定组（B组，n=30）。比较两组患者手术时间、术中出血量、术后24h出血量及术后骨折延迟愈合、骨关节炎、关节挛缩、尺神经麻痹等术后并发症发生率，观察两组患者术后肘关节功能恢复情况。结果B组术后出血量明显少于A组（P〈0．05），而两组术中出血量及手术时间比较差异无统计学意义（P〉0．05）；B组术后肘关节功能优良率明显高于A组（83．3％比63．3％，P〈0．05）；B组术后骨折延迟愈合、骨关节炎、关节挛缩、尺神经麻痹等并发症发生率明显低于A组（13．3％比30．0％，P〈0．05）。结论肱三头肌内外侧入路内固定治疗肱骨髁间骨折疗效显著，术后并发症发生率较低，值得临床广泛应用。

Objective To observe the curative effect of after bilateral triceps approach fixation in the treatment of humeral intercondylar fracture. Methods 60 patients with humeral intercondylar fracture were divided into group A （olecranon osteotomy approach, n=30） and group B （after bilateral triceps approach fixation, n=30） according to the surgical approach. The operation time, intraoperative bleeding volume, postoperative 24 h bleeding, the incidences of postoperative complications such as postoperative delayed fracture healing, osteoarthritis, joint contracture, ulnar nerve paralysis of the two groups were compared. The elbow joint function recovery after surgery of the two groups were observed. Results The postoperative bleeding of group B was significantly less than that of group A （P〈0.05）, but there were no statistically significant differences in the amount of intraoperative bleeding and operation time between the two groups （P〉0.05）. The excellent rate of elbow joint function after operation in group B was significantly higher than that in group A （83.3% vs.63,3%, P〈0.05）. The incidence of postoperative complications （postoperative delayed fracture healing, osteoarthritis, joint contracture, ulnar nerve paralysis） of group B was significantly lower than that of group A （13.3% vs.30.0%, P〈0.05）. Conclusion After bilateral triceps approach fixation in the treatment of humeral intercondylar fracture has distinct curative effect, with low incidence of postoperative complications, worthy of wide clinical application.