肱骨远端关节外锁定加压接骨板治疗肱骨干AO-B、C型骨折

Treatment of type B and Type C fractures of distal humeral shaft by LCP extra-articular distal humerus plate

目的探讨经上臂后外侧入路肱骨远端关节外锁定加压接骨板(LCP-EDHP)内固定治疗肱骨干远端关节外粉碎性骨折的临床疗效。方法自2011-12—2014-02经肱三头肌桡侧入路,向尺侧牵开肱三头肌,不损伤伸肘装置,并采用LCP-EDHP内固定治疗肱骨干远端关节外粉碎性骨折13例。结果所有患者获得随访12~24个月,平均15.2个月。骨折全部愈合,骨折愈合时间为10~15周,平均12.3周。末次随访时肘关节伸直(5.6±5.5)°,屈曲(135.4±11.2)°,前臂旋前(85.6±7.4)°,旋后(86.6±5.9)°。根据Mayo肘关节评分标准:优12例,良1例。1例桡神经麻痹患者为桡神经被骨折端卡压,术后2个月后完全恢复。结论经后外侧入路LCP-EDHP内固定治疗肱骨干远端关节外粉碎性骨折具有不损伤伸肘装置、固定牢固、骨折愈合率高、神经血管结构相对安全、关节功能恢复良好的优点。

Objective To investigate the clinical effect of LCP extra-articular distal humerus plate(LCP-EDHP) through upper arm posterolateral approach for treatment of comminuted extra-articular fractures of the distal humerus. Methods Thirteen patients with comminuted extra-articular fractures of the distal humerus were treated by LCP-EDHP via triceps radialis approach from Dec. 2011 to Feb. 2014. The triceps were pulled to ulnar side without damage of elbow-extension equipment. Results All patients were followed up for 15.2 months(range, 12 to 24 months). Bone union occurred in all patients with 12.3 weeks(range, 10 to 15 weeks). Average elbow extension was(5.6±5.5)° and flexion was(135.4±11.2)°,average forearm pronation was(85.6±7.4)° and supination was(86.6±5.9)° at last follow up. Excellent results were achieved in12 cases and good in 1 case according to the Mayo Elbow Performance Score(MEPS). One case of radial nerve palsy achieved complete recovery 2 months after operation. Conclusion This kind of surgical treatment has good joint function recovery and safe approach of neurovascular structure. It provides rigid fixation and high bone union rate without elbow-extension equipment injury.