Dubberley B型肱骨小头骨折开放复位联合内固定  

Open reduction and combined internal fixations for Dubberley type B capitellum fractures

作　　者：王传鑫 马亮 李景银[1] 谢文鹏 WANG Chuan-xin;MA Li-ang;LI Jing-yin;XIE Wen-peng(Affiliated Hospital,Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Shandong University of Traditional Chinese Medicine,Jinan 250011,China;Shandong Academy of Pharmaceutical Sciences,Jinan 250101,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东中医药大学,山东济南250011 [3]山东省药学科学院,山东济南250101

出　　处：《中国矫形外科杂志》2023年第10期941-944,共4页Orthopedic Journal of China

基　　金：中国博士后科学基金第68批面上资助二等项目(编号:2020M682220);中国博士后科学基金第14批特别资助项目(编号:2021T140423);山东中医药大学附属医院青年创新团队项目支持,人才计划:齐鲁卫生与健康杰出青年人才培养工程;山东省自然科学基金面上项目(编号:ZR2021MH071);泰山学者工程专项经费资助项目(编号:tsqn202211350)。

摘　　要：[目的]探讨微型钢板联合埋头钉、克氏针固定Dubberley B型肱骨小头骨折的临床疗效。[方法]回顾性分析2016年3月—2019年8月本院收治的13例DubberleyB型肱骨小头骨折患者的临床资料。选择肘关节外侧入路并采用微型钢板联合埋头钉及克氏针固定。[结果]手术均完成顺利,无严重医源性损伤发生。平均随访时间(17.5±2.7)个月。恢复患肢完全持重活动时间为(15.3±1.6)周。随时间的推移,13例患者VAS评分显著下降(P<0.05),肘伸屈ROM和MEPS评分显著提升(P<0.05)。术后影像显示,12例解剖复位;1例骨折移位<2 mm,不伴成角或旋转移位。末次随访所有患者均达骨折愈合,无骨块移位,2例轻度骨性关节炎,1例异位骨化并发症。[结论]采用锁定钢板联合埋头钉及克氏针联合固定可有效治疗DubberleyB型肱骨小头骨折。[Objective]To investigate the clinical outcomes of mini plate combined with countersunk screws and Kirschner wire for Dubberley type B capitellum fractures.[Methods]A retrospective study was done on 13 patients who received surgical treatment for Dub-berley type B capitellum fractures in our hospital from March 2016 to August 2019.All patients underwent open reduction and internal fixation with mini plate combined countersunk screws and Kirshner wires through lateral approach.The clinical and imaging consequences were observed.[Results]All the patients had operation completed successfully without serious iatrogenic injuries,and followed up for(17.5±2.7)months on an average with time to resume full weight activity of the affected limb of(15.3±1.6)weeks.The VAS score decreased significantly(P<0.05),whereas elbow extension-flexion ROM and MEPS scores significantly increased in all the 13 patients(P<0.05).Postoperative images showed anatomical reduction in 12 cases,and displacement less than 2 mm without angulation or rotation in one case.At latest follow-up,all patients achieved fracture healing without further displacement of bone fragment,whereas 2 patients had mild osteoarthritis,and one patient had heterotopic ossification.[Conclusion]Mini plate combined with countersunk screw and Kirschner wires does effectively fix Dubberley type B humeral capitellum fracture.

关 键 词：肱骨小头骨折 微型钢板 埋头钉 克氏针 

分 类 号：R683.41[医药卫生—骨科学]