肱骨髁间骨折三种手术入路的临床疗效比较  

Clinical effect of open reduction and internal fixation by three operation approachs on humeral intercondylar fractures

作　　者：田大为[1] 刘娜[2] 谢祥仁[1] 张功礼[1] 钱炜[1] 曹阳[1] 

机构地区：[1]湖北医药学院附属十堰市人民医院骨科,442000 [2]湖北医药学院公共管理学院

出　　处：《中国实用医刊》2013年第9期1-3,共3页Chinese Journal of Practical Medicine

基　　金：湖北省教育厅科学技术研究项目（编号：B20112102）

摘　　要：目的探讨经肱三头肌舌形瓣入路、尺骨鹰嘴截骨入路、肱三头肌两侧入路三种手术入路对肱骨髁间骨折治疗的临床疗效差异性.方法回顾性研究十堰市人民医院2001年1月至2010年10月收治的复杂肱骨髁间骨折92例，分别采用不同手术入路，搜集手术时间、出血、伤口愈合率、骨折愈合率、肘关节功能评分等临床指标。结果手术时间在肱三头肌舌形瓣组、尺骨鹰嘴截骨组和肱三头肌内外侧组分别为（98±31）min，（91±16）min，（132±31）min；出血分别为（70±15）ml、（60±32）ml、（120±30）ml；Mayo肘关节功能评分为（62±15）分、（89±9）分、（75±10）分；关节活动度分别为（76±29）°、（124±19）°、（103±31）°；优良率分别为53．6％、80％、66．6％。结论肱骨髁间骨折治疗比较棘手，经尺骨鹰嘴截骨和经肱三头肌两侧入路为较佳方法，对于C1、C2型肱骨髁间骨折，可以选择经肱三头肌两侧入路，对于C3性骨折，应选择经尺骨鹰嘴截骨。Objective To investigate the treatment effect of humeral intercondylar fractures treated by open reduction and internal fixation via ulna oleeranon osteotomy, bilateral approach through triceps braehii and TRAP on humeral intereondylar fractures. Methods Ninety-two eases of humeral intereondylar fractures admitted in the People＇ s Hospital of Shiyan, between January 2001 and October 2010, were treated by open reduction and internal fixation via three operation approaehs. Datum of operation time, blood loss volume, would and fracture healing rate, Mayo＇ s elbow function score were collected. Results The mean operation time, blood loss volume, Mayo＇ s elbow function score, motion ranges, good and fair rate were （98 ± 31 ） min, （91± 16） rain, （ 132 ± 31 ） rain; （70 ±15） ml, （60 ±32） ml, （120±30）ml; 62±15, 89_9, 75 ±10;（76 ±29）°,（124 ±19）°,（103 ±31） °;53.6%, 80%, 66.6% in three operation approachs. Conclusions Humeral intercondylar fractures defied the surgical treatment and approachs via ulna olecranon osteotomy, bilateral approach through triceps braehii were better than TRAP,bilateral approach through triceps brachii was better choice for type C1 and C2, otherwise approachs via ulna olecranon osteotomy for type C3.

关 键 词：肱骨髁间骨折 手术入路 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]