【摘要】 目的 總結(jié)雙鋼板內(nèi)固定治療復(fù)雜肱骨遠(yuǎn)端骨折的臨床療效。 方法 2004年1月-2008年5月，采用雙鋼板內(nèi)固定治療15例復(fù)雜肱骨遠(yuǎn)端骨折患者。按照AO/ASIF分型，患者均為C型骨折。其中C1型4例，C2型4例， C3型7例。受傷至手術(shù)時(shí)間平均2.5 d。C1、C2型骨折復(fù)位后用雙鋼板固定，C3型骨折復(fù)位后先用細(xì)克氏針固定髁間骨折塊，再用雙鋼板固定。手術(shù)后3～5 d佩帶活動(dòng)型肘關(guān)節(jié)支具進(jìn)行功能鍛煉。隨訪觀察7～16個(gè)月，平均13個(gè)月。按照Mayo評(píng)分標(biāo)準(zhǔn)評(píng)定肘關(guān)節(jié)功能。 結(jié)果 15例患者肱骨髁間及髁上骨折均愈合，時(shí)間為3～6個(gè)月，平均4.5個(gè)月。Mayo評(píng)分：優(yōu)8例，良4例，可2例， 差1例，優(yōu)良率80%。 結(jié)論 對(duì)復(fù)雜肱骨遠(yuǎn)端骨折采取早期切開解剖復(fù)位、雙鋼板內(nèi)固定，使用活動(dòng)型肘關(guān)節(jié)支具進(jìn)行早期功能鍛煉，能顯著降低相關(guān)并發(fā)癥，促進(jìn)肘關(guān)節(jié)功能的恢復(fù)。
引用本文： 易疆鶯,李浩,鄒遠(yuǎn)云,曹萬軍,杏建東,邊防,吳旭東,劉澤宇. 復(fù)雜肱骨遠(yuǎn)端骨折的雙鋼板內(nèi)固定治療. 華西醫(yī)學(xué), 2010, 25(12): 2249-2251. doi: 復(fù)制
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- 2. Morrey BF, An KN, Chao EY, et al. Functional evaluation of the elbow[M]. Morrey BF, The elbow and its disorders. 2nd eds. Philadelphia: Saunder, 1993: 86-89.
- 3. Gainor BJ, Moussa F, Schott T. Healing rate of transverse osteotomies of the olecranon used in reconstruction of distal humerus fractures[J]. J South Orthop Assoc 1995, 4(4): 263-268.
- 4. 周方, 郭琰. 成人肱骨髁間髁上骨折患者術(shù)后肘關(guān)節(jié)功能恢復(fù)的影響因素[J]. 中華創(chuàng)傷骨科雜志, 2006, 8(1): 13-15.
- 5. Eralp L, Kocaoglu M, Sar C, et al. Surgical treatment of distal intraarticular humeral fractures in adults[J]. Int Orthop, 2001, 25(1): 46-50.
- 6. Self J, Viegas SF, Buford WL Jr, et al. A comparison of double-plate fixation methods for complex distal humerus fractures[J]. J Shoulder Elbow Surg, 1995, 4(1): 10-16.
- 7. Korner J, Lill H, Muller LP, et al. The LCP-concept in the operative treatment of distal humerus fractures-biological, biomechanical and surgical aspects [J]. Injury, 2003, 34(Suppl 2): B20-30.
- 8. Browner BD. Skeletal trauma[M]. 2nd ed. Philadelphia: WB Saunders, 1998: 14384-14389.