无头加压全螺纹空心钉治疗严重肱骨髁冠状面Dubberley3型骨折的中期疗效分析

The mid-term curative effect of headless full-thread compression screws in the treatment of severe Dubberley type 3 fracture of coronal plane of humeral condyl

目的探讨经关节面加用无头加压全螺纹空心钉治疗严重老年患者肱骨髁冠状面Dubberley3型骨折的中期疗效及并发症。方法我院采用术中加用无头加压全螺纹空心钉治疗严重肱骨髁冠状面Dubberley3型骨折12例患者,其中10例获得随访,回顾性分析临床及影像学资料。结果所有患者均未发生骨不愈合,末次随访未发现内固定移位、松动、断裂情况,均出现轻度肱骨小头和滑车缺血坏死骨质部分吸收,不同程度肘外翻畸形,空心钉突出骨性关节面情况,末次随访MEPI肘关节评分75~95分,功能恢复优70%,良30%。结论对于严重老年患者肱骨髁冠状面Dubberley3型骨折,经关节面加用无头加压全螺纹空心钉可以让固定方式变得容易,且固定稳定性好,结合术后早期功能锻炼,治疗的中期疗效良好。

Objective To investigate the mid-term efficacy and complications of the articular surface plus the use of a headless compression full-thread cannulated screw in the treatment of severe Dubberley type 3 fractures of coronal plane of humeral condyl in elderly patients.Methods Twelve patients with severe Dubberley type 3 fractures of humeral condyl were treated with intraoperative super-headed full-threaded cannulated screws.Ten of them were followed up for more than 48 months.Clinical and imaging data were retrospectively analyzed.Results All patients had non-union of bone.At the last follow-up,no internal fixation displacement,loosening or rupture were found.All patients had mild humeral head and trochlear ischemic necrosis that was partially absorpted,varying degrees of cubitus valgus deformit and cannulated nails protruded from the osteoarticular surface.The last follow-up MEPI elbow score was 75 ~ 95 points and the excellent and good functional recovery was 70% and 30%,respectively. Conclusion For severe the humerus coronal Dubberley3 Type fractures in elderly patients,the use of headless and full-threaded hollow nails through the articular surface can make the fixation method easy,and the fixation stability is good.Combined with the early functional exercise,the mid-term treatment is good.