肱骨后侧入路手术内固定治疗肱骨中下段骨折36例  

Analysis on the Effectiveness of Humeral Posterior Middle Approach with Internal Fixation for Treatment of Humeral Middle-inferior Fractures

作　　者：张朝晖[1] 孙金琼[1] 郭立利[1] 李祥炎[1] 严小明[1] 

机构地区：[1]福建医科大学附属三明第一医院骨科,福建三明365000

出　　处：《创伤与急危重病医学》2015年第4期198-201,共4页Trauma and Critical Care Medicine

摘　　要：目的探讨肱骨后侧入路手术内固定治疗肱骨中下段骨折的临床疗效。方法对36例肱骨中下段骨折患者进行肱骨后侧入路手术,分别选用合适的钛板内固定。结果骨折达骨性愈合13～16周,平均愈合时间（14.5±1.3）周,术后12～14个月手术取出内固定物。术后随访12～36个月,平均随访（24.3±11.6）个月,骨折均愈合,无切口感染、关节僵硬、神经损伤等并发症发生。肘关节功能按Mayo肘关节功能评定标准（MEPS）评分：优23例,良11例,可1例,差1例,优良率94.4%。11例伴桡神经损伤者功能恢复优8例,良3例,优良率100%。结论肱骨后侧入路手术内固定治疗肱骨中下段骨折临床疗效确切,是一种理想方法。Objective To discuss the curative effect of operative internal fixation treatment in humeral middle-inferior fractures through humeral posterior approach. Methods A total of 36 cases with humeral middle-inferior fractures were treated by internal fixation with straight reconstruction titanium plate,Y-shaped anatomical reconstruction plate and dural plate respectively through humeral posterior middle approach. Each patient was performed early functional exercise under rehabilitation guidance. Results The average osseous healing time of humeral middle-inferior fractures was 13 to 16 weeks（ average of 14. 5 ± 1. 3 weeks）. The internal fixations were removed 12 to 14 months after operation. The time of follow-up was 12 to36 months [average of（ 24. 3 ± 11. 6） months]. All fractures were healed without complications such as infection,nonunion,ankylosis and nerve injury. Outcomes were evaluated according to Mayo Elbow Performance Score（ MEPS） ： 23 cases were excellent,11 cases were good,1 case was fair and bad respectively,the ratio of the excellent and good was 94. 4%.Conclusion Humeral posterior middle approach is an optimal method in internal fixation treatment of humeral middle-inferior fractures.

关 键 词：肱骨骨折 内固定 肱骨后侧入路 肘关节功能 桡神经损伤 

分 类 号：R683.41[医药卫生—骨科学]