两种入路治疗肱骨远端C型骨折的疗效比较  

Comparison effect of two approaches in the treatment of type C fractures of the distal humerus

作　　者：夏玉光 XIA Yu-guang(Dept of Trauma and Joint Surgery,Luoyang Orthopaedic-Traumatological Hospital of Henan Province,Henan Province Orthopaedic Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)创伤与关节外科,河南郑州450000

出　　处：《临床骨科杂志》2022年第5期692-696,共5页Journal of Clinical Orthopaedics

摘　　要：目的 比较鹰嘴截骨入路与肱三头肌两侧入路治疗肱骨远端C型骨折的临床疗效。方法 将45例肱骨远端C型骨折患者按照手术入路不同分为观察组(23例,采用鹰嘴截骨入路肱骨远端解剖锁定钢板治疗)和对照组(22例,采用肱三头肌两侧入路肱骨远端解剖锁定钢板治疗)。记录两组骨折愈合情况、术后并发症发生情况、末次随访时肘关节和前臂旋转活动度。末次随访时采用Mayo评分标准评价肘关节功能。结果患者均获得随访,时间6~12个月。骨折愈合时间观察组短于对照组(P<0.05)。末次随访时,肘关节活动度、前臂旋转度、肘关节功能Mayo评分优良率两组比较差异均无统计学意义(P> 0.05)。两组术后并发症发生率比较差异有统计学意义(P<0.05)。结论 鹰嘴截骨与肱三头肌两侧入路均是治疗肱骨远端C型骨折的有效入路,建议肱骨远端C1型和伴骨质疏松C2型骨折采用肱三头肌两侧入路,部分C2型及C3型骨折采用鹰嘴截骨入路,正确手术入路可提高成功率并减少并发症发生。Objective To compare the clinical effect of olecranon osteotomy approach and bilateral approaches through triceps brachii in the treatment of type C distal humeral fractures.Methods The 45 cases of distal humeral type C fractures were divided into observation group(23 cases, olecranon osteotomy approach) and control group(22cases,bilateral approach through triceps brachii),according to different surgical approaches. The fracture healing conditions,postoperative complications,the activity ranges of elbow joint and foreman rotation at the last follow-up were recorded. Mayo score criterion was used to evaluate the elbow function at the final follow-up.Results All patients were followed up for 6 ~ 12 months. The fracture healing time of the observation group was shorter than the control group(P< 0. 05). At the last follow-up,there were no significant differences in elbow range of motion,forearm rotation range and excellent-good rate of Mayo score between the two groups(P> 0. 05). The complications incidence rate had difference between two groups(P< 0. 05).Conclusions Both approaches are effective for the treatment of type C fractures of distal humerus. For type C1 fractures and C2 fractures with osteoporosis,it is recommended to use the bilateral approaches through triceps brachii,the olecranon osteotomy approach is used in some type C2 and C3 patients,correct surgical approach can improve the success rate and reduce complications.

关 键 词：鹰嘴截骨入路 肱三头肌两侧入路 肱骨远端C型骨折 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学]