肘前入路Herbert螺钉内固定修复肱骨小头骨折:骨折复位及愈合的评价  

Herbert screw fixation for repairing capitellum fracture through anterior elbow approach: evaluation for fracture reduction and healing

作　　者：张奕[1] 陶圣祥[2] 张勇[1] 胡锋[1] 张国华[1] 

机构地区：[1]武汉科技大学附属普仁医院骨科,湖北省武汉市430081 [2]武汉大学附属中南医院骨科,湖北省武汉市430071

出　　处：《中国组织工程研究》2015年第9期1435-1440,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:对于肱骨小头骨折的治疗临床上已经达成初步的共识,就是对有移位的骨折采用切开复位内固定治疗。但是对于选用何种入路以及采用何种内固定物才能达到最佳的固定效果目前尚存争论。目的:探讨经肘前入路Herbert螺钉置入内固定对有移位的肱骨小头骨折的修复效果。方法:选择武汉科技大学附属普仁医院骨科2008年8月至2012年5月收治的有移位的肱骨小头骨折患者12例,均采用经肘前入路Herbert螺钉置入内固定治疗。按Bryan-Morrey分型:Ⅰ型8例,Ⅱ型3例,Ⅲ型1例。观察患者内固定后骨折愈合、肘关节功能恢复及相关并发症发生情况。结果与结论:经过2年随访,12例骨折均达临床愈合,按Mayo肘关节功能评分,优10例,良2例。绝大多数患者肘关节功能恢复正常,无内固定后相关并发症发生。提示经肘前入路Herbert螺钉置入内固定修复有移位的肱骨小头骨折效果满意,内固定后肘关节功能恢复良好,存在明显的优势。BACKGROUND：The treatment of capitel um fracture has obtained primary consensus in the clinic, that is, open reduction and fixation for a displaced fracture. However, the selection of operation approach and the type of internal fixation are stil controversial. OBJECTIVE：To explore the effects of Herbert screw in the treatment of capitel um fracture through anterior elbow approach. METHODS：A total of 12 patients with displaced fractures of the humeral capitel um were chosen from August 2008 to May 2012 in the Department of Orthopedics, Puren Hospital, Wuhan University of Science and Technology. They received Herbert screw fixation through anterior elbow approach. According to Bryan and Morrey classification, there were eight cases of type I fractures, three cases of type II fractures, and one case of type III fracture. The outcomes of fracture healing, elbow functions and complications were observed after fixation. RESULTS AND CONCLUSION：In the two-year fol ow up, fractures in al patients were healed. There were＆nbsp;excel ent in ten patients and good in two patients according the Mayo elbow performance index. The elbow function of most patients recovered to normal. There was no evidence of the post-operative complications. These findings indicate that treatment of displaced capitel um fracture using Herbert screws through anterior elbow approach obtained satisfactory outcomes. The recovery of elbow function was good after fixation, and presented apparent advantages.

关 键 词：植入物 骨植入物 肱骨小头骨折 HERBERT 螺钉 手术入路 肘前入路 内固定 Mayo评分 并发症 关节功能 

分 类 号：R318[医药卫生—生物医学工程]