Y型钛钢板内固定治疗成人肱骨髁间粉碎骨折  

Open reduction and internal fixation for intercondylar comminuted fractures of the humerus in adults by Ytitanium plate

作　　者：苗卫东[1] 曹湘豫[1] 张韶民[1] 柴充[1] 王斌[1] 张长江[1] 

机构地区：[1]河南省平顶山煤业集团总医院骨科,平顶山市467000

出　　处：《中国矫形外科杂志》2005年第14期1058-1059,共2页Orthopedic Journal of China

摘　　要：[目的]报道应用Y型钛钢板内固定治疗肱骨髁间粉碎骨折的方法及疗效。[方法]2000年3月～2004年10月,手术治疗成人肱骨髁间粉碎骨折24例,男18例,女6例;年龄22～56岁,平均37.6岁;右侧16例,左侧8例。根据AOMuller分型,C1型8例,C2型12例,C3型4例。合并尺神经损伤3例。24例均行后路尺骨鹰嘴截骨入路,骨折复位,Y型钛钢板结合松质骨螺钉内固定。Ⅰ期植骨5例。术后24～48h行肘关节CPM器被动活动,1周后肘关节主动锻炼,术后1～6个月内复查X线片3次,了解骨折愈合及肘关节活动情况。[结果]24例均获得随访,随访时间1～3a,平均16个月。骨折全部愈合,肘关节功能恢复满意。根据Cassebaum评分系统评价肘关节术后疗效优8例,良11例,可5例,优良率79.1%。术后伤口感染1例,尺神经损伤加重1例,异位骨化2例。经伤口换药、抗感染及神经营养治疗后恢复。[结论]应用“Y”型钛钢板经尺骨鹰嘴截骨入路内固定治疗肱骨髁间骨折,手术显露充分,骨折达到解剖复位,内固定坚强,术后可早期行肘关节功能锻炼,关节功能恢复满意。[Objective] To report the method and outcome for intercondylar comminuted fractures of the humerus in adults through open reduction and internal fixation with Ytitanium plate.[Method]From March 2000 to October 2004,24 cases of intercondylar comminuted fractures of humerus in adults were reviewed ,which involved 18 males and 6 females with an average age of 36.7 years(range,22～56 years).The fractures were fixed on left side in 8 and on right side in 16.According to AO Muller classification ,there were C_1 in 8,C_2 in 12 and C_3 in 4.Posterior trans-olecranon with open reduction and internal fixation by Ytitanium plate were performed in all 24 cases. All the patients began the passive motion exercises by CPM within 24~48h,and active training after one week postoperatively. X-ray was taken three times in six months after operation to observe the bony union. [Result] All the 24 cases were followed up for 1～3 years (averaged, 16 months),the fracture healed well, and the elbow function recovered satisfactorily .According to the Cassebaum scoring system,8 were assessed as excellent,11 good and 5 fair,and the excellent-good rate was 79.1%. The complications included 1 infection, 1 heavy injuries of the ulnar nerve ,and 2 heterotopic ossification,which recovered by injecting antibiotics and neural nutrients.[Conclusion]The technique of Ytitanium plate for the intercondylar comminuted fractures of the humerus through trans-olecranon approach offers many advantages,such as sufficient exposure,anatomical reduction,stable fixation,earier exercise,and satisfactory ellow function.

关 键 词：肱骨髁间粉碎骨折 内固定治疗 钛钢板 Y型 成人 经尺骨鹰嘴截骨入路 肘关节功能恢复 尺神经损伤 术后伤口感染 肱骨髁间骨折 关节功能锻炼 2004年 2000年 螺钉内固定 手术治疗 骨折复位 Ⅰ期植骨 被动活动 CPM器 主动锻炼 

分 类 号：R687.3[医药卫生—骨科学]