内侧加背外侧双柱90°解剖型钢板治疗肱骨远端C3型骨折15例分析  

The treatment of type C3 distal humeral fractures using medial dorsolateral bicolumnar 90°anatomical plate fixation

作　　者：许克庆 陶钧[1] 汤义民 陈小虎[1] XU Keqing;TAO Jun;TANG Yimin;CHEN Xiaohu(Department of Orthopaedics,Huainan First People’s Hospital,Huainan,Anhui 232007,China)

机构地区：[1]淮南市第一人民医院骨科,安徽淮南232007

出　　处：《安徽医药》2020年第4期700-704,I0003,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨内侧加背外侧双柱90°解剖型钢板内固定治疗肱骨远端C3型骨折手术方法及临床疗效。方法回顾性研究淮南市第一人民医院2016年1月至2018年5月期间15例肱骨远端骨折病人,术前经三维重建CT(Computed Tomography)确诊为AO/OTA(Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation)分型C3型骨折,均采用肘关节后侧经尺骨鹰嘴截骨入路,直接内侧加背外侧双柱90°解剖型钢板内固定治疗。末次随访时使用Mayo评分标准评估肘关节功能。结果病人术后无切口感染、骨折均愈合并获得随访,随访时间范围为6~18个月,随访时间(11.67±3.89)个月。末次随访未见术后内固定松动、断裂及其它严重并发症。采用Mayo肘关节功能评分标准评价:优6例,良9例,优良率100%。结论经尺骨鹰嘴截骨内侧加背外侧双柱90°解剖型钢板内固定治疗肱骨远端C3型骨折,骨折固定可靠,可进行早期肘关节功能锻炼从而获得良好的远期肘关节功能。Objective To discuss thesurgical method and the clinical curative effect of treating type C3(AO/OTA)distal humeral fractures by medial dorsolateral bicolumnar 90°anatomical plate fixation.Methods Fifteen patients with fracture of distal humeral who was diagnosed as Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation(AO/OTA)with 3D reconstruction Computed Tomography(CT)before surgeryinHuainan First People’s Hospital from Jan 2016 to May 2018 were retrospectivelyresearched.All patients were treated by olecranon osteotomy and medial dorsolateral bicolumnar 90°plate fixation.Theelbow functionswere assessed at the last follow up using Mayo scoring system.Results There was no incision disunion,and all the fractures healed.The mean followup time was 6~18 months,average(11.67±3.89)months.There were no postoperative loosen ing,breakage of internal fixationand other serious complications.According to Mayo elbow function scoring system,there were 6 cas es in excellent,9 cases in good,the excellent and good rate was 100%.Conclusion By olecranon osteotomy and medial dorsolater al bicolumnar 90°anatomical plate fixation in the treatment of distal humeral fracture in AO type C3 offers a stable fixation,which permits early postoperative mobilization of elbow joint and good functional outcome for long term.

关 键 词：肱骨骨折 骨折固定术 内 骨板 成像 三维 尺骨鹰嘴 内侧加背外侧双柱 

分 类 号：R683.4[医药卫生—骨科学]