保留鹰嘴关节面的楔形截骨双柱钢板固定对C型肱骨髁间骨折的临床应用  

Clinical application of cuneiform osteotomy and double column plate fixation with olecranon joint surface reserved for type C intercondylar fracture of humerus1

作　　者：李坤庆 王爱兵 刘晟[1] 明亮[1] 吕国阳 LI Kun-qing;WANG Ai-bing;LIU Sheng(Department of Orthopedics,Jianghan Oilfield General Hospital Affiliated to Yangtze University,Qianjiang Hubei 433124,China)

机构地区：[1]长江大学附属江汉油田总医院骨科,湖北潜江433124

出　　处：《临床和实验医学杂志》2020年第18期1964-1967,共4页Journal of Clinical and Experimental Medicine

基　　金：湖北省卫生健康委员会科研项目(编号:WJ2019F152)。

摘　　要：目的观察保留鹰嘴关节面的楔形截骨双柱钢板固定对C型肱骨髁间骨折的临床应用效果与安全性。方法采用前瞻性对照研究方法,选取2015年6月至2018年6月长江大学附属江汉油田总医院收治的62例C型肱骨髁间骨折患者,采用随机数字表法将患者分为观察组和对照组,每组各31例,均行保留鹰嘴关节面的楔形截骨术式治疗,观察组患者行双柱钢板固定,对照组患者行克氏针张力带固定。比较两组患者的手术情况、恢复情况、并发症发生情况以及术后肘关节功能Mayo评分、肘关节功能优良率。结果观察组患者的手术时间、术中出血量、术后开始锻炼时间分别为(117.26±6.59)min、(210.28±35.91)ml、(1.55±0.29)d,均低于对照组的(131.84±6.92)min、(242.49±33.08)ml、(3.57±0.91)d,差异均具有统计学意义(P<0.05)。观察组患者的术后并发症发生率为3.23%(1/31),低于对照组的19.35%(6/31),差异具有统计学意义(P<0.05)。末次随访时,观察组患者的Mayo评分总分为(92.29±5.41)分,较对照组的(81.75±5.03)分更高,差异具有统计学意义(P<0.05)。末次随访时,观察组患者的肘关节功能优良率为83.33%(25/30),高于对照组的68.97%(20/29),差异具有统计学意义(P<0.05)。结论对于C型肱骨髁间骨折患者而言,在保留鹰嘴关节面并采取楔形截骨的前提下,行双柱钢板固定较克氏针张力带固定更有助于患者术后恢复及肘关节功能改善,且安全性更高。Objective To observe the clinical effect and safety of C-type intercondylar fracture of humerus treated with cuneiform osteotomy and double column plate.Methods From June 2015 to June 2018,62 patients with type C intercondylar fracture of humerus in Jianghan Oilfield General Hospital Affiliated to Yangtze University were randomly divided into observation group and control group,31 cases in each group.All patients were treated with wedge osteotomy with preservation of olecranon articular surface.Patients in observation group were treated with double column plate fixation,while patients in control group were treated with Kirschner wire tension band fixation.The operation,recovery,complications,Mayo score and excellent and good rate of elbow function were compared between the two groups.Results The operation time,intraoperative hemorrhage and postoperative exercise time of the observation group were(117.26±6.59)min,(210.28±35.91)ml,(1.55±0.29)d,respectively,which were lower than those of the control group(131.84±6.92)min,(242.49±33.08)ml,(3.57±0.91)d,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 3.23%(1/31),lower than that in the control group(19.35%)(6/31),the difference was statistically significant(P<0.05).At the last follow-up,the total score of Mayo in the observation group was(92.29±5.41),which was higher than that in the control group(81.75±5.03).The difference was statistically significant(P<0.05).At the last follow-up,the excellent and good rate of elbow joint function in the observation group was 83.33%,higher than 68.97% in the control group,the difference was statistically significant(P<0.05).Conclusion For the patients with type C intercondylar fracture of humerus,double column plate fixation is more helpful to the postoperative recovery and improvement of elbow joint function than Kirschner wire tension band fixation on the premise of retaining the olecranon joint surface and wedge osteotomy,and the safety is highe

关 键 词：C型肱骨髁间骨折 鹰嘴关节面 楔形截骨 双柱钢板固定 

分 类 号：R687.3[医药卫生—骨科学]