肱骨髁间骨折的手术治疗  

Surgical treatment of intercondylar fractures of humerus

作　　者：陈红卫[1] 姜丹生[2] 林平[2] 

机构地区：[1]义乌市中心医院骨科,浙江义乌322000 [2]金华市中心医院骨科

出　　处：《中国骨伤》2006年第1期11-13,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的：分析手术复位钢针张力带固定和内外侧双钢板固定治疗肱骨髁间骨折的临床疗效。方法：自1999年1月-2004年2月，手术治疗肱骨髁间骨折48例，按Riseborough分型：Ⅱ型6例，Ⅲ型13例，Ⅳ型29例。手术入路采用经肱三头肌两侧入路28例，尺骨鹰嘴截骨入路20例；内固定方法包括钢针张力带固定23例，内外侧双钢板固定25例。术后早期行功能锻炼。结果：本组48例均获随访，时间12-48个月，平均31个月，用改良Cassebaum评分系统评定肘关节功能，优21例，良18例，可6例，差3例，优良率为81．3％。术后3例关节间隙轻度狭窄和边缘骨赘形成，异位骨化2例，无伤口感染和骨不连，4例尺神经损伤均完全恢复，无一例发生迟发性尺神经炎。结论：经肱三头肌两侧入路和尺骨鹰嘴截骨入路显露肱骨髁间骨折，显露充分，钢针张力带和内外侧双钢板能提供有效固定，合理地运用手术入路和内固定方式，早期行功能锻炼，可取得满意的临床疗效。Objective： To analyze the clinical effect of intercondylar fracture of humerus with open reduction and internal fixation with tension band or double plate. Methods. From January 1999 to February 2004,48 patients with intercondylar fracture of humerus were treated with open reduction. According to classification of Riseborough,type Ⅱ had 6 cases,type Ⅲ 13 cases and type Ⅳ 29 cases. Of them,28 cases were treated through the bilateral approach through triceps braehii and 20 cases through olecranon osteotomy approach. 23 cases were fixed with tension band and 25 cases with double plate. Results： 48 patients were followed up from 12 to 48 months with an average of 31 months. Depending on Cassebaum＇s scoring system of function of elbow joint,21 cases obtained excellent, 18 good, 6 fair and 3 poor, the rate of excellent and good were 81.3%. Conclusion： The bilateral approach through triceps brachii and olecranon osteotomy approach could provide adequate exposure for visualization. Tension band and double plate could provide for reliable fixation. It could make satisfactory clinical results through choosing suitable surgical approach, internal fixation methods and early exercises.

关 键 词：肱骨髁间骨折 骨折固定术 内 张力带固定 双钢板固定 

分 类 号：R683.41[医药卫生—骨科学] R683.420.5[医药卫生—外科学]