锁定联合非锁定双直型重建钛板垂直固定治疗肱骨髁C型骨折的临床研究

Clinical study of locking and non locking reconstruction plates vertical fixation for treatment of humeral intercondylar fractures(Type C)

目的:探讨经肱三头肌舌形瓣入路,锁定联合非锁定双重建钛板垂直固定与Y形及双重建钢板平行固定在治疗肱骨髁C型骨折中临床疗效。方法:分别用锁定联合非锁定双重建板垂直、Y形钢板及双重建板平行固定治疗肱骨髁C型骨折患者59例,双钢板垂直组27例;Y形钢板组15例;双钢板平行组17例。对比术中出血量和手术时间;术后并发症、骨折愈合时间;术后肘关节功能恢复情况。结果:所有患者随访3~12个月,Mayo肘关节功能评估:A组优18例、良6例、可2例、差1例;优良率88.89%。B组优4例、良5例、可4例、差2例;优良率60.00%。C组优11例、良4例、可1例、差1例;优良率88.23%。结论:锁定联合非锁定双重建钛板垂直固定较Y形钢板和双钢板平行固定治疗肱骨髁间骨折术后功能恢复好。

Objective:To investigate the clinical effect of three kinds of different fixation methods(locking and non locking plates,Y-type steel plate and double plates) for intercondylar humeral fractures via the triceps tongue shaped flap approach.Methods:Fifty nine patients with adult humeral intercondylar fracture were divided into three groups.The locking and non locking plates vertical fixed group has 27 cases,Y-shape plate fixed group includes 27 cases,and the double plates parallel fixed group contains 17 cases.The following aspects were analyzed:bleeding during operation,operation time,postoperative complications,the time of fracture healing,postoperative function of elbow joint.Results:All patients were followed up for 3-12 months.According to Mayo elbow scoring system,A group:excellent in 18 cases,good in 6 cases,fair in 2 cases and poor in 1 cases,the excellent and good rate was 88.89%.B group:excellent in 4 cases,good in 5 cases,fair in 4 cases and poor in 2 cases,the excellent and good rate was 60.00%.C group:excellent in 11 cases,good in 4 cases,fair in 1 cases and poor in 1cases,the excellent and good rate was 88.23%.Conclusions:Comparing with the Y-shape plate fixation and the double plates parallel fixation,treatment of comminuted humeral intercondylar fracture(Type C) using the locking and non locking plates vertical fixation technique has good therapeutic effects.