上臂后侧入路双接骨板内固定治疗肱骨中下段1／3骨折的疗效分析  

Double plate fixation via the upper arm posterior approach for fractures of middle-inferior humerus

作　　者：陈健荣[1] 吴峰[1] 张宏宁[1] 包杭生[1] 邹泽良[1] 

机构地区：[1]广东省佛山市中医院骨科,528000

出　　处：《中华创伤骨科杂志》2017年第7期630-633,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨通过上臂后侧经肱三头肌联合腱内缘入路双接骨板内固定治疗肱骨中下段1／3骨折的临床疗效。方法回顾性分析2013年5月至2015年5月应用上臂后侧经肱三头肌联合腱内缘入路切开复位双接骨板内固定治疗的32例肱骨中下段1／3骨折患者资料。男19例，女13例；年龄17～54岁，平均36．8岁；左侧14例，右侧18例。骨折AO分型：B型21例，C型11例；均为闭合性骨折。术后定期复查X线片，末次随访时根据Jupiter肘关节评分系统评价肘关节功能。结果32例患者术后获6—20个月（平均11．5个月）随访。骨折愈合时间为4～7个月，平均5．0个月。肘关节屈曲活动度1200．135°，平均125°；伸直活动度0～8°，平均5°。术后无一例患者发生切口感染、钢板断裂、骨折不愈合等并发症。末次随访时根据Jupiter肘关节评分系统评价肘关节功能：优15例，良14例，可3例，优良率为90．6％。结论通过上臂后侧经肱三头肌联合腱内缘入路切开复位双接骨板内固定治疗肱骨中下段1／3骨折，具有操作简单、复位满意、固定牢固、疗效满意等优点。Objective To investigate the clinical outcomes of treating fractures of the middle-inferior humerus with double plate fixation via the upper arm posterior approach through the inner edge of the joint triceps tendon. Methods From May 2013 through May 2015, 32 fractures of the middle-inferior humerus were treated with open reduction and double plate fixation by the upper arm posterior approach via the inner edge of the joint triceps tendon. They were 19 males and 13 females, aged from 17 to 54 years （mean, 36.8 years） . In- volved were 14 left sides and 18 right sides. By AO classification, 21 cases were type B and 11 type C, all closed fractures. X-ray examinations were regularly conducted at postoperative follow-ups; function of the elbow joint was assessed according to the Jupiter elbow joint grading system at the final follow-up. Results All the 32 patients were followed up for 6 to 20 months （average, 11.5 months） . The fractures healed after 4 to 7 months （average, 5.0 months） . The flexion ranged from 120° to 135° （average, 125°）, and the extension ranged from 0 to 8° （average, 5°）. There were no such complications as postoperative infection, plate breakage, or nonunion. According to the Jupiter elbow joint grading system at the final follow-up, there were 15 excellent cases, 14 good ones, and 3 fair ones, giving a good to excellent rate of 90.6%. Conclusion Open re- duction and double plate fixation by the upper arm posterior approach via the inner edge of the joint triceps tendon is simple for fractures of the middle-inferior humerus and leads to satisfactory reduction, reliable fixation, and fine outcomes.

关 键 词：肱骨骨折 肘关节 骨折固定术 内 骨板 

分 类 号：R687.3[医药卫生—骨科学]