尺骨鹰嘴截骨入路治疗DubberleyⅢ型肱骨远端冠状面骨折  

Olecranon osteotomy approach for Dubberley typeⅢcoronal fractures of the distal humerus

作　　者：刘凯 胡建炜 陈允周 尚如国 喻永新 LIU Kai;HU Jan-wei;CHEN Yun-zhou;SHANG Ru-guo;YU Yong-xin(Guangzhou Orthopaedics Hospital,Guangzhou 510000,Guangdong,China)

机构地区：[1]广州市正骨医院,广东广州510000

出　　处：《中国骨伤》2023年第2期156-160,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:回顾性分析经尺骨鹰嘴截骨入路治疗DubberleyⅢ型肱骨远端冠状面骨折的临床效果并总结治疗经验。方法:自2016年1月至2020年6月,采用经尺骨鹰嘴截骨入路治疗DubberleyⅢ型肱骨远端冠状面骨折17例,男5例,女12例;年龄37~78(58.5±12.9)岁。按Dubberley分型:ⅢA型5例,ⅢB型12例。术后根据Borberg-Morrey肘关节功能评分标准进行疗效评价,同时记录术后肘关节的屈伸及旋转活动度、并发症情况,并进行术后影像学评估。结果:17例患者术后骨折均获得骨性愈合。随访时间12~33(15.6±5.6)个月。无骨折不愈合,肱骨小头缺血性坏死1例,创伤性关节炎2例及异位骨化1例,骨折畸形愈合1例。术后肘关节屈伸活动度(114.80±19.50)°,Broberg-Morrey评分(85.3±8.2)分,优5例,良9例,一般3例,差0例。结论:经尺骨鹰嘴截骨入路可充分显露肱骨远端关节面,手术操作方便,肱骨远端关节面的解剖复位和牢固固定是保证治疗效果的关键。Objective To retrospectively analyze the clinical efficacy of olecranon osteotomy approach in the treatment of Dubberley typeⅢcoronal fractures of the distal humerus and summarize the treatment experience.Methods From January 2016 to June 2020,17 patients(5 males and 12 females)with Dubberley typeⅢcoronal fractures of the distal humerus were treated by olecranon osteotomy approach.The age ranged from 37 to78 years old with an average of(58.5±12.9)years old.According to Dubberley classification,there were 5 cases of typeⅢA and 12 cases of typeⅢB.The curative effect was evaluated using the Borberg-Morrey elbow function score.The flexion,extension and rotation range of motion of the elbow joint,complications and postoperative imaging evaluation were recorded.Results All the 17 patients got bony union.The follow-up time ranged from 12 to 33 months with an average of(15.6±5.6)months.There was 1 case of ischemic necrosis of capitulum humeri,2 cases of traumatic arthritis and 1 case of heterotopic ossification,1 case of malunion of fracture.The range of motion was(114.80±19.50)°.The Broberg-Morrey score was 85.3±8.2,excellent in 5 cases,good in 9 cases,fair in 3 cases and poor in 0 case.Conclusion Through olecranon osteotomy approach,the articular surface of distal humerus could be fully exposed,and the operation is convenient.Anatomical reduction and rigid fixation of the articular surface of distal humerus are the key factors for the succesful outcome.

关 键 词：尺骨鹰嘴截骨入路 肱骨远端冠状面骨折 内固定 

分 类 号：R683.41[医药卫生—骨科学]