肱骨解剖锁定钢板固定治疗肱骨关节外骨折对肘关节功能的影响  

Functional outcomes of the distal humeral fractures managed with anatomic shaped extra-articular distal humerus locking plates by dorsolateral approach

作　　者：郑建荣 黄玉良[1] 巫红波 邬哲慧[1] 陈锐雄[1] ZHENG Jianrong;HUANG Yuliang;WU Hongbo;WU Zhehui;CHEN Ruixiong(Department of Orthopedics and Traumatology,Huizhou Center People's Hospital of Guangdong Province,Huizhou 516001,China)

机构地区：[1]惠州市中心人民医院创伤骨科,广东惠州516001

出　　处：《包头医学院学报》2021年第3期50-54,共5页Journal of Baotou Medical College

摘　　要：目的:分析肱骨远端后外侧解剖锁定钢板固定治疗肱骨中下段关节外骨折对肘关节功能的影响。方法:选取2017年2月至2019年12月收治的126例肱骨中下段关节外骨折患者为研究对象,随机将其分为后外侧入路组和前外侧入路组;两组患者均进行解剖锁定钢板固定治疗,后外侧入路组采用肱骨远端后外侧入路,前外侧入路组采用前外侧入路;术后随访6个月,比较两组患者手术指标、肘关节功能恢复情况及桡神经损伤情况。结果:后外侧入路组患者的手术时间、术中出血量、下床活动时间、住院时间及骨折愈合时间均低于前外侧入路组(P<0.05);两组患者的术前及术后3个月肘关节屈曲及伸直活动度相比,差异无统计学意义(P>0.05);术前两组患者的Mayo关节功能评分比较,差异无统计学意义(P>0.05),术后3个月后外侧入路组Mayo关节评分高于前外侧入路组(P<0.05),后外侧入路组患者的肘关节功能恢复优良率高于前外侧入路组(P<0.05);两组患者的桡神经损伤比较,发生率差异无统计学意义(P>0.05)。结论:后外侧解剖锁定钢板内固定治疗肱骨中下段关节外骨折效果较好,肘关节功能恢复良好,且桡神经损伤发生率未增加,值得推广。Objective:To explore and analyze the effect of anatomic shaped extra-articular distal humerus locking plates on the fixation of extra-articular distal humerus factures.Methods:126 patients of extra-articular distal humerus fractures,who were operated between February 2017 and December 2019,were selected,and all of them were managed with anatomic shaped extra-articular distal humerus locking plates.Patients in group A were operated with dorsolateral approach while group B used the anterolateral approach.The regular 6-month follow-up was done to evaluate and compare the operation indicators,elbow functionality,and radial nerve injury.Results:The operation time,peri-operation blood loss,postoperative activity time,hospital stays and fracture healing time in group A were significantly shorter than those in group B(P<0.05).There was no significant difference of elbow flexion and joint extension in the two groups before the operation and 3 months after the operation(P>0.05).There was no significant difference of Mayo score before the operation(P>0.05),but 3 months after the operation Mayo score in group A was significantly higher than that in group B(P<0.05).The excellent rate of elbow function recovery in group A was higher than that in group B(P<0.05);there was no significant difference in radial nerve injury in the two groups(P>0.05).Conclusion:The application of anatomic shaped extra-articular distal humerus locking plates in distal humeral shaft fractures by dorsolateral approach shows satisfactory outcomes with better elbow functionality recovery,so more clinical application and assessments should be considered.

关 键 词：肱骨中下段骨折 切开复位内固定 前外侧入路 后外侧入路 

分 类 号：R687.3[医药卫生—骨科学]