Schildhauer入路与鹰嘴截骨入路复位内固定对肱骨远端C型骨折患者关节功能及手术创伤程度的影响

Effects of Schildhauer approach and olecranon osteotomy approach reduction and internal fixation on joint function and surgical trauma degree in patients with type C fracture of distal humeru

目的探讨Schildhauer入路与鹰嘴截骨入路复位内固定治疗肱骨远端C型骨折患的效果。方法选取2019年1月至2021年1月我院收治的120例肱骨远端C型骨折患者作为研究对象,按术式不同将其分为A组和B组,各60例。A组采用Schildhauer入路复位内固定手术,B组采用鹰嘴截骨入路复位内固定手术。比较两组的治疗效果。结果术后1 d,A组的肾上腺素(E)、皮质醇(Cor)、醛固酮(ALD)水平均低于B组(P<0.05)。A组的手术时间短于B组,术中出血量少于B组(P<0.05)。术后6个月,A组的肘关节外旋、内旋、屈伸活动范围大于B组(P<0.05)。术后6个月,A组的Mayo、Neer评分均高于B组(P<0.05)。两组的术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论Schildhauer入路复位内固定治疗肱骨远端C型骨折患者能减小创伤,改善肘关节活动度,促进肘肩关节功能恢复,值得推广。

Objective To investigate the effect of Schildhauer approach and olecranon osteotomy approach reduction and internal fixation in the treatment of type C fracture of distal humeru.Methods A total of 120 patients with type C fracture of distal humeru admitted in our hospital from January 2019 to January 2021 were selected as the research objects.According to the difference of surgical methods,the patients were divided into group A and group B,with 60 cases in each group.The group A was treated with Schildhauer approach reduction and internal fixation,and the group B was treated with olecranon osteotomy approach reduction and internal fixation.The therapeutic effects of the two groups were compared.Results One day after operation,the levels of epinephrine(E),cortisol(Cor)and aldosterone(ALD)in the group A were lower than those in the group B(P<0.05).The operation time of the group A was shorter than that of the group B,and the intraoperative blood loss was less than that of the group B(P<0.05).At 6 months after operation,the range of external rotation,internal rotation,flexion and extension of elbow joint in the group A were larger than those in the group B(P<0.05).At 6 months after operation,the Mayo and Neer scores in the group A were higher than those in the group B(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Schildhauer approach reduction and internal fixation in the treatment of patients with type C fracture of distal humeru can reduce trauma,improve elbow mobility,and promote the recovery of elbow and shoulder joint function,which is worthy of promotion.