改良前外侧入路双钢板治疗肱骨中下段骨折的疗效分析  

Clinical Efficacy Analysis of Modified Anterolateral Approach with Double Plates on the Treatment of Fracture of Middle and Lower Humerus

作　　者：游景扬 范江荣 郑勇 石振 许益文 郑波 沈思齐 YOU Jingyang;FAN Jiangrong;ZHENG Yong;SHI Zhen;XU Yiwen;ZHENG Bo;SHEN Siqi(Department of Orthopedic Trauma,Xianning Central Hospital,Xianning 437100,Hubei China)

机构地区：[1]咸宁市中心医院创伤骨科,湖北咸宁437100

出　　处：《中国中医骨伤科杂志》2022年第10期66-70,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：咸宁市中心医院院级项目(2018XYB001)。

摘　　要：目的:探讨改良前外侧入路双钢板内固定治疗肱骨中下段骨折的临床疗效。方法:回顾性分析2016年1月至2021年1月采用改良前外侧切口切开复位双钢板内固定治疗的62例肱骨中下段骨折患者资料,并与同期采用前外侧切口单钢板固定肱骨中下段骨折的患者临床疗效比较。其中男39例,女23例;年龄为21~65岁,平均为41.5岁;左侧22例,右侧40例。骨折AO分型:B型26例,C型36例。均为闭合性骨折,其中6例患者术前有桡神经损伤。术后定期复查X线片,根据Mayo肘关节功能评分评估肘关节功能。结果:所有患者术后获得10~18个月随访(平均14.0个月)。骨折愈合时间为4.5~8.0个月,平均为5.0个月。肘关节屈曲活动度为120°~140°,平均为120°;伸直活动度为0°~10°,平均为5°。术后无患者发生切口感染、钢板断裂、骨折不愈合等并发症;有1例患者发生医源性桡神经损伤,术后半年自行恢复;6例术前有神经症状患者均在术后3~9个月恢复。末次随访时根据Mayo肘关节功能评分评价肘关节功能:优24例,良32例,可6例,优良率为90.3%。与同期单钢板固定疗效相比,Mayo肘关节功能评分差异无统计学意义(P>0.05),术后并发症方面差异有统计学意义(P<0.05)。结论:肱骨中下段骨折采用改良前外侧切口切开复位双钢板内固定,具有固定牢固、防止复位丢失的优点,临床疗效满意。与单钢板固定相比,更适用于C型骨折,有利于缩短钢板固定长度,减少并发症。Objective:To investigate the clinical efficacy of modified anterior lateral approach with double plate internal fixation on the treatment of mid-lower segment fractures of the humerus.Methods:A total of 62 cases with fracture of the middle and lower tibia were treated by modified anterior lateral incision and reduction of double plate internal fixation from January 2016 to January 2021,and the clinical efficacy was compared with anterolateral incision single plate fixation of lower humeral fractures during the same period.There were 39 males and 23 females, aged from 21 to 65 years old with 41.5 years old on average.22 cases were on the left hand while 40 cases on the right.The AO classification of fractures: type B in 26 cases and type C in 36 cases, all of which were closed fractures, including 6 patients with radial nerve injury before operation.X-ray films were reviewed regularly after surgery, and elbow joint function was evaluated according to the Mayo elbow joint function scores at the last follow-up.Results:62 patients were traced for 10 to 18 months, with 14.0 months on average.The fracture healing time was 4.5 to 8.0 months, with 5.0 months on average.The flexion activity of the elbow joint was 120° to 140°,with 120° on average;the straightening activity was 0° to 10°,with 5° on average.No one had the complications such as wound infection, plate rupture, and nonunion of the fracture and so on.1 patient had the iatrogenic radial nerve injured and recovered spontaneously half a year later.All of 6 patients with neurological symptoms before surgery recovered 3 to 9 months after the operation.The evaluation of elbow joint function according to the Mayo elbow joint function scores at the last follow-up showed that: excellent in 24 cases, good in 32 cases, and fair in 6 cases.The pass rate was 90.3%.Compared with the efficacy of single plate fixation during the same period, there was no significant difference in the Mayo elbow joint function scores, and there was a statistical significance in postoperat

关 键 词：肱骨骨折 肘关节 骨折内固定术 骨板 

分 类 号：R683.41[医药卫生—骨科学]