支撑钢板治疗肱骨远端冠状面骨折  

Surgical treatment of coronal plane shear fractures of the distal humerus in adults by support steel plate

作　　者：宋文奇[1] 张弛[1] 王挺[1] 韩培[1] 郑宪友[1] 孙鲁源[1] 康庆林[1] 柴益民[1] 张长青[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《实用手外科杂志》2013年第2期112-114,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨支撑钢板治疗肱骨小头冠状面骨折的方法及疗效。方法2008年2月-2012年7月，采用支撑钢板治疗肱骨远端冠状面骨折8例。根据国际通用的Dubberley分型，IA型3例，IIA型5例，均为闭合性损伤。全部切开，直视下骨折复位。经X线透视确认解剖复位后采用支撑钢板固定。结果术中及术后无神经、血管损伤，X片示骨折解剖复位。本组8例均获随访．随访时间为8-24个月，平均16个月，未发现肱骨小头缺血坏死，无肘关节外翻不稳，其中1例出现创伤性关节炎表现。骨折愈合时间为6-10周。肘关节活动度：伸90（0°-15°），屈1250（105°～135°），平均活动度116°。按BrobergMorrey评分标准，平均94．2分；术后疗效优6例，良1例，可1例，优良率为87．5％。结论肱骨小头冠状面骨折应行切开复位支撑钢板内固定术，达到解剖复位和牢固固定后．早期行肘关节主动伸屈功能锻炼．可获得满意疗效。Objective To investigate the surgical treatment and outcome of coronal plane shear fractures of the distal humerus by the support steel plate. Methods Eight patients with closed shear fracture of the distal humerus were surgically treated by open reduction and internal fixation of the support steel plate from February 2008 to January 2012. All the fractures were classified as Dubberley suggested in type IA （3 cases）, type IIA （5 cases）. All were closed injury. Under the direct vision, the support steel plate was used after anatomic reduction was confirmed by fluoroscopy. Results All fractures were reduced anatomically without any neural or vascular injury during and after operations. The mean following-up was 16 months （range, 8-24 months）. The results were excellent in 6 cases and good in 1 case. The mean Broberg- Morrey score was 94.2, while the average arc of motion was 116°. Conclusion Opening reduction and fixing with the support steel plate are suitable for the coronal plane shear fractures of the distal humerus. Prompting treatment with anatomic reduction and internal fixation and early rehabilitation could lead to excellent or good outcomes.

关 键 词：肱骨小头 滑车 骨折 内固定 支撑钢板 

分 类 号：R683.41[医药卫生—骨科学]