鹰嘴截骨入路双柱固定治疗中青年肱骨髁间粉碎骨折的疗效评价  

Treatment of distal humerus comminuted fractures by the double column olecranon osteotomy fixation

作　　者：闻伟敬[1] 尹芸生[1] 王东[1] 卢汉生[1] 郭昊宇[1] 李鹏彪[1] 潘晋平[1] 

机构地区：[1]山西医科大学第二临床医学院骨创组,太原030001

出　　处：《中国医疗前沿》2010年第13期47-49,共3页China Healthcare Innovation

摘　　要：目的介绍尺骨鹰嘴截骨应用双钢板固定治疗中青年肱骨远端髁间粉碎骨折(C2和C3型)的应用及疗效评价。方法 35例肱骨远端粉碎性骨折,均采用经尺骨鹰嘴截骨入路,骨折复位后配合拉力螺钉、双钢板固定。结果肱骨远端骨折按照AO/ASIF分型标准,C2(干骺端粉碎)型13例,C3(关节粉碎或不伴干骺端粉碎)型22例。术后平均随访时间30个月,肱骨髁间骨折34例愈合,1例延迟愈合,平均愈合时间3.9个月。所有截骨块全部愈合,平均愈合时间8周。肘关节MEPS功能评分,优10例,良19例,可4例,优良率82.85%。结论经尺骨鹰嘴截骨入路,应用双钢板治疗中青年肱骨髁间粉碎性骨折(C2和C3型),暴露充分、骨折固定牢靠、力学性能稳定、并发症少,能早期进行肘关节功能锻炼,获得了良好的疗效。Objective To introduce the treatment of distal humerus comminuted fractures by the double column olecranon osteotomy fixation in the youth and summarize its therapeutic effects.Methods 35 cases with distal comminuted humeral fracture in the youth were treated with internal fixation using two plates through a trans olecranon osteotomy approach.After reposition fragments were fixed by pulling nails,and block osteotomy were fixed by U steel wire.Results According to AO/ASIF classification,type C2 in 13 and C3 in 22 cases were followed up for 30 months on average,and all fracture healed in 3.9 months averagely.Of these 35 cases,all the osteotomies healed in 8 weeks averagely.According to mayo elbow function rating system,the elbow joint function was evaluated,and the results showed excellent in 10,good in 19,fair in 4 and the excellence rate was 82.85%.Conclusion Internal fixation with the double column plate through approach of extra-articular oblique osteotomy of olecranon in patients with intercondylar distal humeral fracture（C2 and C3） has many advantage,it provides satisfactory stability with simple technical procedure and solid fixation,and it facilitates rehabilitation exercises and provides good results with low complication rate.

关 键 词：肱骨髁间骨折 中青年 尺骨鹰嘴截骨 双柱固定 

分 类 号：R683.41[医药卫生—骨科学]