肱骨髁间粉碎性骨折双钢板垂直与平行固定疗效比较  

作　　者：时超[1] 王冠[1] 程飞[1] 罗仲伟[1] 

机构地区：[1]南京中医药大学附属徐州市中医院骨科,江苏徐州221002

出　　处：《临床医药文献电子杂志》2016年第47期9346-9348,9351,共4页Electronic Journal of Clinical Medical Literature

摘　　要：目的分析双铜板垂直与平行固定治疗肱骨髁间粉碎性骨折的临床疗效，探讨较为合适的内固定方案。、方法回顾性分析2013年6月至2015年9月在我院进行双钢板治疗的肱骨髁间粉碎性骨折并符合入选标准的患者49例。其中双钢板垂直固定组（Orthogonal plating Group，OPG）23例（男性13例，女性10例），平均年龄36．4±9．1岁（19～67岁）；左侧8例，右侧15例。双钢平行板固定组（Parallel plating Group，PPG）26例（男性14例，女性12例），平均年龄38．6±10．9岁（19～71岁）；左侧10例，右侧16例。记录两组患者的人口统计学资料、术前和术后的影像学资料及临床资料，并进行统计学分析。结果两组患者性别分布、年龄、患肢分布及骨折分型均无统计学差异（P〉0．05）。所有患者肱骨髁间粉碎性骨折均愈合。患侧肘关节屈伸活动度OPG为（108±24）°，PPG为（114±19）°（P〉0．05）。患侧前臂旋转活动度OPG为（169±16）°，PPG为（157±14）°（P〉0．05）。双钢板垂直固定组MEPS评分为（87±10）分，优良率为92％，双铜板平行固定组MEPS评分为（90±6）分，优良率为96％（P〉0．05）。结论双铜板垂直与平行固定治疗肱骨髁间粉碎性骨折均能够获得满意的临床效果。可以根据术者的熟练程度、骨折分型和粉碎程度及患者骨骼质量选择合适的内固定方式。Objective To evaluate the clinical outcomes between orthogonal and parallel plating methods with dual-plate for the treatment of humeral condylar comminuted fractures （HCCF） , and to investigate which is the better choice. Methods A retrospective review was performed on all HCCF patients who were treated at our department between June 2013 and September 2015. A subset of 49 patients, including 23 （ 13 female/10 male ; average age 36. 4±9. 1 years ; 8 left/15 right） treated with orthogonal plating method （ Or- tbogonal plating Group, OPG） and 26 （ 14 female/12 male; average age 38.6±10. 9 years; 10 left/16 right） treated with parallel plat- ing method （Parallel plating Group, PPG） , was finally enrolled according to the inclusion criteria. Demographic data, radiographic and clinical outcomes of the patients pre-and post-operative were recorded and analysed. Results Gender, age, distribution of the hurt limb and fracture classification were matched between the two groups. All fractures were healed at the follow-up. Arc of elbow flexion and extension, arc of forearm rotation, MEPS and rate of excellent/good outcomes between OPG and PPG were （ 169± 16） ° and （ 114± 19）°, （169±16） ° and （157±14） °, （87±10） points and （90±6） points, 92% and 96% respectively （P〉O. 05）. Conclusion Both orthogonal and parallel plating methods for the treatment of humeral condylar comminuted fractures could achieve satisfactory clini- cal outcomes. In addition, the operator may choose the appropriate fixation method bested on their skilled level, fracture classification, degree of comminuted and bone mass.

关 键 词：肱骨髁间粉碎性骨折 双钢板垂直固定 双钢板平行固定 

分 类 号：R658.3[医药卫生—外科学]