肱骨远端C型骨折手术治疗的研究进展

Research progress in surgical treatment for type C fractures of the distal humerus

肱骨远端C型骨折在临床中较为罕见,主要通过对患者实施手术治疗,达到对断面准确复位及关节面重建的目的,在当前切开复位固定是目前最为理想的治疗方案。尺骨鹰嘴截骨入路可为临床治疗提供充足的视野,是临床中较为常用的手术入路方式,但这种范式却存在截骨处愈合差、内固定失败等不良反应发生。为了确保对患者的治疗效果,避免对鹰嘴完整性的牺牲,在医学技术的大力发展下,出现了多种入路方式进行治疗。但研究发现,不同入路方式治疗中具有一定的局限性,因而在临床治疗中对入路选择在输液入路与肘功能影响中存在一定的矛盾。随着“双柱”理论的推广应用,双钢板固定C型骨折在临床中受到了广泛的使用,且在体外力学实验中体现了更佳优势。

Type C fractures of the distal humerus are relatively rare in clinical practice.Surgical treatment is mainly used to achieve accurate reduction of the cross-section and reconstruction of the articular surface.At present,open reduction and internal fixation are the most ideal treatment options.The olecranon osteotomy approach can provide sufficient visual field for clinical treatment,and is a commonly used surgical approach in clinical practice.However,this paradigm has adverse reactions such as poor union at osteotomy and internal fixation failure.In order to ensure the treatment effect for patients and avoid sacrificing the integrity of the olecranon,under the vigorous development of medical technology,a variety of approaches have emerged for treatment.However,studies have found that different approaches have certain limitations in the treatment,so there is a certain contradiction between the infusion approach and the influence of elbow function in the clinical treatment of the approach.With the popularization and application of the"double-column"theory,the dual-plate fixation of type C fractures has been widely used in clinical practice,and has shown better advantages in in vitro mechanical experiments.