经肱三头肌入路切开复位钢板内固定治疗肱骨中段骨折  

Treatment of Humerus shaft fracture in the middle with plate fixation through trioeps brachii approach.

作　　者：王爱兵[1] 熊南平[1] 刘晟[1] 李坤庆[1] 

机构地区：[1]湖北江汉油田总医院骨科,潜江433124

出　　处：《骨科》2013年第3期139-141,共3页ORTHOPAEDICS

摘　　要：目的探讨经肱三头肌入路切开复位钢板内固定治疗肱骨中段骨折的临床疗效。方法采用经肱三头肌入路切开复位钢板内固定治疗38例肱骨中段骨折,按AO/ASIF分型:A型16例,B型14例,C型8例。结果 38例患者获得随访,随访时间为9.0～24.0个月,平均14.6个月。1例合并桡神经断裂术后桡神经功能恢复差。1例出现肱骨骨折不愈合、内固定物松动。其余37例骨折愈合良好,愈合时间8.0～18.0周,平均12.6周,无感染、迟发性臂外侧间隙卡压综合征形成。肩关节功能按Neer评分标准:优32例,良3例,可2例,差1例,优良率92.1%;肘关节功能按Mayo评分标准:优32例,良2例,可2例,差2例,优良率89.5%。结论经肱三头肌入路切开复位钢板内固定治疗肱骨中段骨折,可直接显露并保护好桡神经及其分支,减少桡神经损伤,钢板固定在张力侧符合生物力学,利于骨折愈合;并发症较少,疗效满意。Objective To investigate the clinical outcome of internal fixation with plate fixators through the trioeps brachii approach.Methods Thirty-eight patients with humeral shaft fractures in the middle（AO/ASIF Classification： A in 16 cases,B in 14 cases,and C in 8 cases） were treated with plate fixators through the trioeps brachii approach.Results All patients were followed up for 9-24 months（mean 14.6 months）.Fractures were primarily healed,and the mean bone union time was 12.6 weeks（8-18 weeks）.During the follow-up period,there was no infection and entrapment syndrome of lateral intermuscular septum of arm.According to Neer score for shoulder function,32 cases obtained excellent effectiveness,3 cases good,2 cases fair and 1 case poor,with the excellent and good rate being 92.1%.According to Mayo score for elbow function,32 cases obtained excellent effectiveness,2 cases good,2 cases fair and 2 cases poor,with the excellent and good rate being 89.5%.Conclusion Treatment of humeral shaft fracture with plate fixation through the trioeps brachii approach has the advantages including the direct exposure and protection of the radial nerve,the solid internal fixation of the plate,and the quick union of the fracture.

关 键 词：肱骨 骨折 内固定器 

分 类 号：R687.3[医药卫生—骨科学]