改良上臂前外侧入路治疗肱骨中下段骨折  

Treatment of Middle-Distal Humeral Fractures by Improved Anterolateral Approach of Upper Arm

作　　者：林洪光[1] 陈昆[1] 王鸿泰[1] 刘爱刚[1] 郑文忠[1] 

机构地区：[1]解放军第180医院骨科,福建泉州362000

出　　处：《实用骨科杂志》2013年第11期978-979,983,共3页Journal of Practical Orthopaedics

摘　　要：目的研究改良上臂前外侧人路钢板内固定治疗肱骨中下段骨折的临床疗效。方法自2006年10月至2012年03月采用改良上臂前外侧入路钢板内固定治疗肱骨中下段骨折172例，其中男117例，女55例；年龄17～65岁，平均38．3岁。新鲜骨折157例，陈旧性骨折15例；闭合性骨折146例，开放性骨折26例。结果本组病例随访1～6年（平均3．9年），根据HSS肘关节和Neer肩关节评分标准评定疗效，优139例，良26例，差7例，优良率95．9％。本组病例切口均一期愈合，未出现医源性桡神经损伤、内固定失败、骨折不愈合、骨化性肌炎等并发症。结论改良上臂前外侧人路钢板内固定治疗肱骨中下段骨折，不需常规游离暴露长段桡神经，钢板与桡神经有软组织相隔，避免医源性桡神经损伤，钢板放置与骨面贴合，避免钢板扭转塑形，复位满意，固定牢靠，术后并发症少，恢复快，疗效确切。Objective To explore the clinical efficacy of internal fixation with plate by improved anterolateral approach of upper arm in the treatment of middle - distal humeral fractures. Methods Internal fixation with plate by improved anterolater- al approach of upper arm was applied in the operation of 172 cases of middle - inferior humeral fractures from 2006 to 2012. Results All patients were followed up for 1 years to 6 years （ average 3.9 years）. According to Neer and HSS~ evaluation cri- teria,there were excellent in 139 cases, good in 26 cases, and excellent and good rate was 95.9%. Operative incisions of all these cases healed. There were no complications of iatrogenic radial nerve injury,internal fixation failure, bone nonunion, myo- sitis ossificans. Conclusion Internal fixation with plate by improved anterolateral approach of upper arm in the treatment of middle - distal humeral fractures avoid the iatrogenic radial nerve injury and has the advantages of minimal trauma, satisfactory reduction, solid fixationg, good postoperative function, and better results.

关 键 词：改良上臂前外侧入路 肱骨中下段骨折 骨折内固定术 

分 类 号：R683.42[医药卫生—骨科学]