成人肱骨远端关节面移位骨折的手术治疗

Surgical treatment of displaced fracture on adult humeral distal end joint plate

目的 观察成人肱骨远端关节面移位骨折的手术疗效。方法 经切开复位、克氏针内固定治疗 4 4例成人肱骨远端经关节面移位骨折。根据患者自述、临床检查及X线摄片 ,并以健侧肘关节功能活动为标准判定疗效 ;同时对影响疗效的相关因素进行探讨。结果 术后随访 8～ 30个月 (平均16个月 ) ,优良 2 4例 ,满意 12例 ,差 8例 ,优良率 5 4 5 5 %。主要并发症有 :肘关节僵硬 7例 ,克氏针针尾戳破皮肤感染 4例 ,创伤性关节炎 3例 ,骨化性肌炎 2例。结论 克氏针内固定治疗成人肱骨远端经关节面移位骨折 ,疗效可靠 ;手术时机、切口感染、复位质量。

Objective To observe the curative effect of operation on displaced fracture of adult humeral distal end joint plate. Methods 44 cases of adult fracture on humeral distal end joint plate were treated by open reduction and Kirchner's pin internal fixation. The patients were followed up for an average of 16 months after operation. The curative effect was evaluated according to the patients' self statements, clinical examination, X ray and function activities of the other good elbow joint. Meanwhile the relative factors influencing the curative effect were discussed. Results 44 patients were followed up from 8～30 months(16 months on average). 24, 12 and 8 cases obtained excellent, good and bad results, respectively. The excellent rate was 54 55%. The main complications, included good 7 cases of elbow joint stiffness, 4 cases of skin infection resulted from Kirchner's pin end stabbing skin, 3 cases of traumatic arthritis, and 2 cases of ossifying myositis. Conclusion The Kirchner's pin can be used to cure adult dislocation fracture on humeral distal end joint plate internal fixation with reliable curative effect. The factors influencing the curative effect include operation time, wound infection, fracture dislocation quality and the time to fix elbow joint.