双钢板与单钢板内固定治疗AO-C型肱骨中下段骨折的早期疗效比较  

A short-term clinical efficacy of dual plate vs. single plate in treatment of AO type C mid-distal humeral fractures

作　　者：张欣[1] 杨军[1] 王维[1] 许晓军[1] 王湛[1] 高明 ZHANG Xin;YANG Jun;WANG Wei;XU Xiao-jun;WANG Zhan;GAO Ming(Department of Orthopedics,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110004,China)

机构地区：[1]中国医科大学附属盛京医院创伤骨科,辽宁沈阳110004

出　　处：《中国骨与关节损伤杂志》2018年第9期925-928,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较双钢板与单钢板内固定治疗AO-C型肱骨中下段骨折的临床疗效。方法回顾性分析自2010-04—2016-04诊治的57例AO-C型肱骨中下段骨折,26例采用双钢板内固定治疗(双钢板组),31例采用单钢板内固定治疗(单钢板组)。比较2组手术时间、术中出血量、住院时间、骨折愈合时间,末次随访时肘关节功能Mayo评分、疼痛VAS评分,以及骨折不愈合或延迟愈合发生率。结果双钢板组获得(20.3±1.7)个月随访,单钢板组获得(23.6±1.8)个月随访。双钢板组骨折愈合时间较单钢板组短,差异有统计学意义(P <0.05);但2组手术时间、术中出血量、住院时间,以及末次随访时肘关节功能Mayo评分、疼痛VAS评分比较差异无统计学意义(P>0.05)。双钢板组1例骨折延迟愈合,经非手术治疗,术后24周骨折愈合。单钢板组4例骨折不愈合,经翻修手术后骨折愈合;1例骨折延迟愈合,经非手术治疗,术后22周骨折愈合。双钢板组骨折不愈合或延迟愈合发生率低于单钢板组,但差异无统计学意义(P>0.05)。结论双钢板内固定治疗肱骨中下段骨折可以提供更佳的生物力学稳定性,在骨折远端可以多平面不同角度置入足够数量的螺钉以保证坚强内固定,骨折愈合时间更短。Objective To evaluate the clinical efficacy of dual plate and single plate in the treatment of AO type C mid-distal humeral fractures. Methods A retrospective analysis of 57 cases of AO type C mid-distal humeral fractures with surgical treatment during April 2010 to April 2016 was conducted. Twenty-six cases were treated with double plate internal fixation （dual plate group）, while 31 cases treated with single plate internal fixation （single plate group）. The operative time, intraoperative blood loss, hospitalization time, fracture healing time, elbow joint Mayo score, VAS score and the rare of postoperative nonunion and delayed healing were compared between the two groups. Results The follow-up time of the dual plate group was （20.3±1.7） month, and the single plate group was （23.6±1.8） month. Double plate group fracture healing time was shorter than single plate group, there was statistically significant difference （P 〈0.05）. In the time of operation, intraoperative blood loss, the hospitalization time, the Mayo score, and the VAS score, there were no statistically significant differences between the two groups （P 〉0.05）. One patient in the double plate group had delayed fracture healing, and after non-surgical treatment, the fracture healed 24 weeks after surgery. In the single plate group, 4 fractures did not heal, and the fracture healed after revision surgery; One patient had fracture delayed healing, with non-surgical treatment, fracture healed at 22 weeks after operation. The incidence of nonunion or delayed healing in the double plate group was lower than that in the single plate group, but the difference was not statistically significant （P 〉0.05）. Conclusion Double plate internal fixation for the treatment of the distal third humeral fractures can provide better biomechanical stability. A sufficient number of screws can be placed at different angles of the distal end of the fracture to ensure strong internal fixation and shorter fracture healing time.

关 键 词：肱骨中下段骨折 双钢板 单钢板 肱骨远端锁定加压钢板 内固定 骨折不愈合 

分 类 号：R687.3[医药卫生—骨科学]