改良尺骨鹰嘴截骨治疗肱骨髁间骨折  

Modified osteotomy of olecranon for the management of inter-condylar fracture of the humerus

作　　者：梅正峰[1] 雷文涛[1] 黄东辉[1] 赵琦辉[1] 瞿杭波[1] 倪连之 

机构地区：[1]杭州市第三人民医院,浙江杭州310009

出　　处：《中国骨伤》2017年第1期86-88,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨改良尺骨鹰嘴截骨治疗肱骨髁间骨折的手术方法和疗效。方法:2007年5月至2012年12月采取改良尺骨鹰嘴截骨入路治疗肱骨髁间骨折32例,男21例,女11例;年龄18~65岁,平均46.3岁;右侧19例,左侧13例。AO分型,C1型7例,C2型11例,C3型14例;开放性骨折5例(GustiloⅠ型3例,GustiloⅡ型2例)。6例合并其他处骨折,4例合并尺神经损伤,2例合并桡神经损伤。术后定期复查及X线检查,按Cassebaum评分系统评定肘关节功能。结果:32例均获随访,时间9个月~5年,平均1.9年;截骨块愈合时间6~10周,平均7.4周。未发生尺骨鹰嘴关节内骨折,无截骨块不愈合。2例肘后内固定隆起处屈肘轻度疼痛不适,1例骨折块松动,2例出现异位骨化。肘关节功能评定:优19例,良8例,可4例,差1例。结论:改良尺骨鹰嘴截骨治疗肱骨髁间骨折具有不侵袭关节、术中截骨简便、固定简单、截骨块力学稳定性好、截骨并发症发生率低等优点。Objective：To explore the surgical method and clinical outcome of modified osteotomy of olecranon for the treatment of inter-condylar fracture of humerus. Methods：From May 2007 to December 2012,32 patients of intercondylar fracture of humerus were treated surgically through the approach of modified osteotomy of oleeranon. The patients were 21 males and 11 females with a mean age of 46.3 years （ranged 18 to 65 years）. Nineteen fractures occurred on the right extremity and 13 on the left extremity. According to the AO classification, type C 1 fracture was found in 7, C2 in 11 and C3 in 14. Five patients suffered from open fracture （Gustilo type I in 3 ,type Ⅱ in 2）. Other fractures occurred in 6 patients and the primary injury of nerve occurred 6. The healing of the osteotomy was evaluated with physical examination and plain X-ray film, and the function of elbow was assessed according to Cassebaum scale. Results： All the patients were followed from 9 months to 5 years （average, 1.9 years ）. All the osteotomies healed at 7.4 weeks averagely after operation, and no nonunion, delayed union, fracture of ulna olecranon were found. Two cases had little pain on the elbow, heterotopic ossification occurred in 2 cases and cutting bone block loosed in 1 case. The function of the elbow showed excellent in 19 cases,good in 8 ,fair in 4 and poor in 1. Conclusion：The use of the approach of modified olecranon osteotomy for surgical management of intercondylar fracture of humerus has some advantages, it provides satisfactory stability with simple technical procedures avoiding inter-articular invasion, and it facilitates rehabilitation exercises and providing good results with low complication rates.

关 键 词：肱骨骨折 尺骨鹰嘴 截骨术 

分 类 号：R683.41[医药卫生—骨科学]