经肱三头肌劈开入路AO双钢板治疗肱骨髁间骨折  

AO double plate for treatment of intercondylar fractures of the humerus via triceps-splitting approach

作　　者：戴思雨 季祝永 张文祥 韩乃富 谭相齐 陈余庆 

机构地区：[1]兴化市第一人民医院,江苏兴化225700

出　　处：《创伤外科杂志》2010年第6期517-519,共3页Journal of Traumatic Surgery

摘　　要：目的探讨经肱三头肌劈开入路应用AO双钢板治疗肱骨髁间骨折的方法和临床疗效。方法 2004年6月~2009年3月采用经肱三头肌劈开入路结合AO双钢板治疗肱骨髁间骨折25例,男性16例,女性9例;年龄18~65岁,平均41.6岁。按照AO/ASIF分类：C1 7例,C2 12例,C3 6例。结果术后24例复位满意,1例复位较差;无切口感染,2例术中牵拉损伤尺神经。21例获得随访,时间9~36个月,平均22.3个月。尺神经损伤恢复,骨折全部愈合,无内固定松动及断裂,愈合时间14~24周,平均17周。根据改良的Cassebaum法评分：优5例,良12例,可4例,差1例;优良率80.9%。结论经肱三头肌劈开入路显露骨折充分,AO双钢板治疗肱骨髁间骨折是目前治疗肱骨髁间骨折的较好方法,能有效地防止骨折不愈合,并可满足患者早期进行关节功能锻炼。Objective To explore the surgical management and its effect of AO double plate in treating intercondylar fractures through triceps-splitting approach.Methods From Jul.2004 to Mar.2009,25 patients of intercondylar fracture of humerus were treated with AO double plate internal fixaton through triceps-splitting approach.There were 16 males and 9 females,with a mean age of 41.6 years（range 18-65 years）.According to AO/ASIF classification,there were 7 cases of type C1,12 cases of type C2,6 cases of type C3.Results Satisfactory reduction was achieved in 24 cases,poor reduction in 1 case.No incision infection was observed.Ulnar nerve injury was observed intraoperatively in 2 cases.Twenty-one patients were followed up for 9-36 months（average 22.3 months）.Of the 21 patients,all fractures healed,injured ulnar nerve recovered.There was no loosening and breakage.The healing time was 14-24 weeks,averaging 17 weeks.The function of the elbow（according to Cassebaum scale） showed excellent in 5 cases,good in 12,fair in 4 and poor in 1.The excellent and good rate was 80.9%.Conclusion The technique of AO double plate for treating intercondylar fracture of humerus through triceps-splitting approach has advantages of good anatomical reduction,stable fixation and early functional exercise.

关 键 词：肱骨骨折 内固定 疗效 

分 类 号：R683.41[医药卫生—骨科学]