肱骨髁间及髁上骨折选用3种手术入路内固定治疗效果分析

Treatment effect analysis of 3 kinds of surgical approach internal fixation in the treatment of humeral intercondylar and supracondylar fracture

目的:分析选用3种手术入路内固定治疗肱骨髁间及髁上骨折的效果。方法:收治肱骨髁间及髁上骨折的患者50例,采用不同的手术入路进行治疗,3种手术入路分别为肱三头肌舌形瓣入路21例,肱三头肌劈开入路18例和尺骨鹰嘴截骨入路11例。结果:3种手术方法的手术疗效优良率分别为60%、56%、91%。结论:3种手术入路治疗肱骨髁间及髁上骨折各有优缺点,其中经尺骨鹰嘴截骨入路适合于C2和C3型患者,效果尤为显著,经肱三头肌劈开适合于C1型患者,而经肱三头肌舌形瓣手术入路的远端显露比较有限,但这种入路不太利于患者术后进行早期功能锻炼,致使治疗效果相对较差。

Objective:To analyze the treatment effect of 3 kinds of surgical approach internal fixation in the treatment of humeral intercondylar and supracondylar fracture.Methods:50 patients with humeral intercondylar and supracondylar fracture were selected.Different surgical approaches were used for treatment.The 3 surgical approaches including approach of extra-articular osteotomy of olecranon in 21 cases,triceps splitting approach in 18 cases and olecranon osteotomy approach in 11 cases.Results:The excellent and good rate of 3 kinds of surgical methods were 60% ,56% ,91% .Conclusion:3 surgical approaches for the treatment of intercondylar and supracondylar fractures of the humerus have their respective advantages and disadvantages.The olecranon osteotomy approach is suitable for patients with type C2 and type C3,and the effect is particularly significant.Triceps splitting approach is suitable for patients with type C1,while the extra-articular osteotomy of olecranon to the distal end is relatively limited,however,this approach is not conducive to patients with early postoperative functional exercise,resulting in relatively poor therapeutic effect.