改良空心钉复位尺骨鹰嘴截骨结合垂直锁定钢板治疗C型肱骨远端骨折临床效果观察  

Clinical observation of modified hollow nail reduction of olecranon osteotomy combined with vertical locking plate in treatment of C-type distal humerus fracture

作　　者：李晗[1] 吴冯胜[1] 徐执扬[1] 吴飞华[1] 苏新杰[1] 梁喜斌[1] LI Han;WU Fengsheng;XU Zhiyang;WU Feihua;SU Xinjie;LIANG Xibin(Department of Traumatic Orthopedics,Beijing Chuiyangliu Hospital(Chuiyangliu HospitalAffiliated to Tsinghua University),Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院(清华大学附属垂杨柳医院)骨一科,北京100022

出　　处：《中国医学工程》2023年第10期54-58,共5页China Medical Engineering

摘　　要：目的探讨改良空心钉复位尺骨鹰嘴截骨结合垂直锁定钢板治疗C型肱骨远端骨折临床效果。方法回顾选取2016年2月至2021年11月,在北京市垂杨柳医院骨科就诊的C型肱骨远端骨折患者15例,应用尺骨鹰嘴截骨入路治疗,尺骨鹰嘴截骨部复位采用1枚6.5 mm空心钉结合钛缆张力带的复位固定方式,术后支具固定及适当功能练习。结果15例患者均获得随访,切口均一期愈合。术后未出现切口感染、血管神经症状等并发症。肱骨远端骨折均愈合,平均愈合时间12.6周,钢板、螺钉位置良好;尺骨鹰嘴截骨处骨性愈合,未发生移位、骨不连等情况。随着术后愈合时间的增加,术后12个月时,平均肘关节屈曲角度为(119.33±11.63)°。末次随访按照Mayo肘关节功能评分标准,平均85(65~95)分。优7例,良5例,可3例,差0例,优良率80%。结论采用尺骨鹰嘴截骨入路治疗C型肱骨远端骨折效果满意;改良6.5mm空心钉结合钛缆张力带复位尺骨鹰嘴截骨部操作简单,预后良好。【Objective】To investigate the clinical effect of modified hollow nail reduction of olecranon osteotomy combined with vertical locking plate in the treatment of C-type distal humerus fracture.【Methods】Fifteen patients with C-type distal humerus fracture admitted to the Department of Orthopedics,Beijing Chuiyangliu Hospital from February 2016 to November 2021 were retrospectively selected.They were treated with ulna olecranon osteotomy approach.The olecranon osteotomy was reduced by a 6.5 mm hollow nail combined with titanium cable tension band.Postoperative brace fixation and appropriate functional exercise were adopt.【Results】All the 15 patients were followed up and all the incisions healed in one stage.There were no postoperative complications such as incision infection,vascular and neurological symptoms.The fractures of distal humerus were all healed with a mean healing time of 12.6 weeks.The osteotomy of the olecranon was bony healed without displacement or nonunion.With the increase of postoperative healing time,the mean elbow flexion angle was 119.33±11.63°at 12 months.At the last follow-up,the average score was 85(65-95)according to the Mayo Clinic Elbow Function Scale.Seven cases were excellent,5 cases were good,3 cases were fair,0 case was bad,the excellent and good rate was 80%.【Conclusion】The ulna olecranon osteotomy approach was used to treat C-type distal humerus fractures with satisfactory results.Reduction of olecranon osteotomy with modified 6.5mm hollow nail combined with titanium cable tension band is simple and has good prognosis.

关 键 词：C型肱骨远端骨折 尺骨鹰嘴截骨 改良空心钉 张力带 

分 类 号：R687.3[医药卫生—骨科学]