双锁定加压钢板治疗肱骨干下段骨折  

Double locking compression plates for distal humeral shaft fractures

作　　者：赵义磊[1] 刘中何[1] 王国栋[1] 申智中 ZHAO Yi-lei;LIU Zhong-he;WANG Guo-dong;SHEN Zhi-zhong(Department of Emergency,First Afiliated Hospital,Xirxiang Medical University,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院急诊科,河南新乡453100

出　　处：《中国矫形外科杂志》2020年第12期1094-1097,共4页Orthopedic Journal of China

摘　　要：[目的]探讨双锁定加压钢板对肱骨干下段骨折的临床效果。[方法]回顾性分析2015年2月~2018年2月本院接受手术治疗的100例肱骨干下段骨折患者临床资料,依据内固定方式分为两组,双钢板组50例给予肱骨远端外侧和前内侧双钢板内固定治疗,单钢板组50例仅使用肱骨远端外侧单钢板内固定治疗。比较两组围手术期、随访和影像资料。[结果]两组均顺利完成手术,除单钢板组出现2例桡神经损伤外,术中无严重并发症。两组手术时间、术中出血量、住院时间的比较差异无统计学意义(P>0.05)。两组患者随访12个月以上,双钢板组主动活动、完全负重活动时间均显著早于单钢板组(P<0.05)。随术后时间推移,两组ROM和Mayo评分均显著增加(P<0.05);末次随访时,双钢板组ROM和Mayo评分显著高于单钢板组(P<0.05)。术后影像显示,两组患者骨折复位满意,无明显残余畸形。至术后12个月,双钢板组50例中,49例已骨性愈合,1例影像显示延迟连接,但内固定物无松动。单钢板组50例中,48例已骨性愈合,2例骨不连接,其中1例内固定物未松,另1例内固定物松动。[结论]双锁定加压钢板固定肱骨干下段骨折有利于患者功能恢复。[Objective]To evaluate the clinical outcomes of double locking compression plates for distal humeral shaft fractures.[Methods]A retrospective study was done on 100 patients who underwent surgical treatment for distal humeral shaft fracture from February 2015 to February 2018 in our hospital.Based on implant used,50 patients had open reduction and internal fixation(ORIF)with double plates,one on the lateral side and one on the anteromedial side of the distal humerus,while other 50 patients received ORIF with only a single plate on the lateral side of the distal humerus.The perioperative,follow-up and radiographic documents were compared between the two groups.[Results]All the patients in both groups had operation performed successfully without serious complications except radial nerve injury in 2 patients of the single plate group.There were no significant differences regarding to operation time,intraoperative blood loss and hospital stay between the two groups(P>0.05).The patients were followed up for more than 12 months.The double plates groups returned to active elbow motion and full-weight bearing activity significantly earlier than the single plate group(P<0.05).Both the ROM and Mayor score significantly increased over time in both groups(P<0.05).At 12 months after operation,the double plates group proved significantly superior to the single plate group in ROM and Mayor score(P<0.05).With respect to radiographic assessment,all patients achieved proper fracture reduction without remarkable residual deformity after operation.To the latest follow up,all patients in the double plates group got bony healing except one of delayed union without implant loosening,in contrast,2 patients in the single plate group suffered from delayed union,one with implant loosening and one without loosening.[Conclusion]The double locking compression plates for internal fixation of distal humeral shaft fractures facilitate functional recovery.

关 键 词：肱骨干下段骨折 开放复位内固定 双钢板 单钢板 

分 类 号：R683.41[医药卫生—骨科学]