经肱三头肌内外侧联合入路双钢板内固定治疗肱骨髁间骨折的临床研究  

Clinical study of treatment of intercondylar fractures of the distal humerus by double plate fixation via combined medial and lateral triceps approach

作　　者：朱俊锟[1] 应锦河[1] 柳育健[1] 

机构地区：[1]温州医学院附属第五临床医学院丽水市中心医院骨科,浙江323000

出　　处：《中华手外科杂志》2009年第4期205-207,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨经肱三头肌内外侧联合入路（triceps—sparing approach，TSA）双钢板内固定治疗C1、C2型（A0／ASIF）肱骨髁间骨折的疗效。方法对7例肱骨髁间粉碎性骨折（C1型3例，C2型4例）的患者，采用经肱三头肌内外侧联合入路，双钢板及髁间空心钉固定。结果术后随访时间为8～18个月，平均15个月。根据Mayo评分系统（MEPS）评定：优5例，良2例。肘关节平均屈曲角度为（118．6±11．4）°，平均伸直角度丢失（22．9±12．1）°，肘关节携带角（20±5）°。无一例出现内固定松动、断裂。结论经肱三头肌内外侧联合人路治疗C1、C2型肱骨髁间骨折是较理想的手术入路，具有暴露充分、骨折达到良好复位固定及术后早期康复等优点。Objective To evaluate the treatment results of double plating of type C1, C2（AO/ASIF） intereondylar fractures of the distal humerus through combined mediolateral triceps-sparing approach （TSA）. Methods A retrospective analysis of 7 eases of intereondylar comminuted fractures of the distal humerus was conducted. There were 3 cases of type CI and 4 cases of type C2. All the patients were treated with open reduction and double plate and eannulated screw fixation through combined mediolateral triceps-sparing approach. Results Postoperative follow up period was 15 months （range, 8 to 18 months）. Results were evaluated using the Mayo Elbow Performance Score （MEPS）. Five eases were graded as excellent, while 2 eases good. Average elbow flexion was （ 118.6 ± 11.4）°. Average extension lag was （22.9 ± 12.1 ）°. Carrying angle was （20 ± 5）°. No implant loosening or breakage was noted. Conclusion Combined mediolateral TSA is an ideal approach for fixation of type C1, C2 intercondylar fractures of the distal humerus in that it provides adequate exposure to the fracture site, facilitates fracture reduction and allows early rehabilitation.

关 键 词：肱骨骨折 骨折固定术 内 骨科手术方法 

分 类 号：R686[医药卫生—骨科学]