V型骨刀在肱骨远端C3型骨折临床应用

V-type Osteotome via Olecranon Osteotomy for the Treatment of Distal Humeral C3 Fractures

目的:比较肱三头肌入路术式与V型骨刀行尺骨鹰嘴截骨术对肱骨远端C3型骨折的临床疗效观察及术后肘关节功能影响分析。方法:选取25例肱骨远端骨折C3型患者,根据手术方案的不同分为2组,对照组13例肱三头肌入路手术治疗,观察组12例V型骨刀尺骨鹰嘴V型截骨术治疗。对比2组手术时间、术中出血量、骨折愈合时间等临床情况,比较2组术后6个月肘关节活动度和Broberg-Morrey肘关节功能评分情况,比较2组切口感染、尺神经炎、骨化性肌炎、内固定失败等并发症发生率。结果:25例获得随访,随访时间6-12个月,观察组手术时间短、术中出血量小,优于对照组,纽间有差异(P<0.05),骨折愈合时间观察组略优于对照组,组间无差异(P>0.05)。观察组8.33%并发症总发生率,低于对照组30.76%,组间有差异(P<0.05)。结论:V型骨刀行尺骨鹰嘴截骨术治疗肱骨远端C3型骨折,手术时间较短,术中出血量较少,可较好恢复肘关节功能,同时减少并发症,值得临床推广。

Objective:To compare the clinical effect of traditional triceps approach and v-type osteotome for C3 distal humerus fracture and the influence of elbow function.Methods:25 patients with C3 type distal humerus fracture were selected and divided into two groups according to different surgical regimens.13 patients in the control group received traditional surgery via triceps approach.In the observation group,12 cases were treated with v-type osteotome via olecranon osteotomy.The operation time,intraoperative blood loss and fracture healing time of the two groups were compared.Elbow range of motion and Broberg-Morrey elbow function scores were compared between the two groups 6 months after surgery.The incidence of incisional infection,ulnar neuritis,myositis ossificans and failure of internal fixation were compared between the two groups.Results:The 25 patients were followed up for 6-12 months.The observation group had shorter operation time and smaller intraoperative blood loss,which was better than the control group(P<0.05).The fracture healing time of the observation group was slightly better than that of the control group,with no difference between the groups(P>0.05).The total incidence of complications in the observation group(8.33%)was lower than that in the control group(30.76%),and there was a difference between the groups(P<0.05).Conclusion:V-type osteotome via olecranon osteotomy for the treatment of distal humeral C3 fractures,shorter operation time,less intraoperative blood loss,can better restore elbow joint function,while reducing complications,it is worthy of clinical promotion.