雙重建鋼板治療粉碎性肱骨髁間骨折

劉明建

[摘要] 目的 探討雙重建鋼板治療粉碎性肱骨髁間骨折的結(jié)果。方法 收集肱骨髁間粉碎性骨折32例,男19例,女13例。采用雙重建鋼板固定,術(shù)后早期功能鍛煉。結(jié)果 32例患者均獲隨訪,時間10-32個月。根據(jù)Cassebaum系統(tǒng)評定肘關(guān)節(jié)術(shù)后功能:優(yōu)22例,良7例,差3例。結(jié)論 雙重建鋼板治療粉碎性肱骨髁間骨折能達(dá)到解剖復(fù)位,提供牢固持久的固定,術(shù)后可以早期行功能鍛煉,促進肘關(guān)節(jié)功能的恢復(fù),是一種比較有效的方法,可取得滿意的療效。

[關(guān)鍵詞] 肱骨髁間骨折;骨折;粉碎性;雙重建鋼板;骨折固定術(shù)

[中圖分類號] R683[文獻(xiàn)標(biāo)識碼] A[文章編號] 1004-8650(2009)05-09-03

Effect of dual reconstruction steel plate in the treatment of comminuted intercondylar fracture of humerus

LIU Ming-jian

(Shipai Hospital,Dongguan,GuangDong,523330)

[Abstract] Objective To observe the clinical efficacy of dual reconstruction steel plate in the treatment of comminuted intercondylar fracture of humerus. Methods 32 cases of comminuted intercondylar fracture of humerus treated with dual reconstruction steel plate and done early functional exercises after operations were collected. There were 19 men and 13 women in the cases. Results 32 cases were observed in 10-32 month. There were 22 excellent cases,7good cases and 3 bad cases by Cassebaum standards of elbow joint function after operation. Conclusion Dual reconstruction steel plate in the treatment of comminuted intercondylar fracture of humerus could anatomical reset and provide long-lasting firmly fixation to humerus. Dual reconstruction steel plate and early functional exercises after operations in the treatment of comminuted intercondylar fracture of humerus was an effective method of promoting elbow joint function.

[Key words] intercondylar fracture of humerus;comminuted fracture; dual reconstruction steel plate; fixation of fracture

肱骨髁間骨折是一種較難處理的骨折,由于肱骨滑車及肱骨髁的內(nèi)外側(cè)柱均為粉碎性骨折,術(shù)中對骨折的復(fù)位非常困難,也很難做到堅強的內(nèi)固定,術(shù)后的早期功能也無從進行,近年來多趨向于早期切開復(fù)位內(nèi)固定治療,術(shù)后早期進行積極的關(guān)節(jié)功能鍛煉。筆者2000年3月-2008年10月,采用雙重建鋼板法治療粉碎性肱骨髁間骨折32例,效果滿意。

1材料與方法

1.1病例資料

本組32例,男19例,女13例,年齡23-70歲。左側(cè)18例,右側(cè)14例。按AO /ASIF分型:C1型11例,C2型16例,C3型5例。其中開放性骨折6例:CusstiloⅠ度損傷4例,Ⅱ度損傷2例。合并尺神經(jīng)損傷2例。

1.2手術(shù)方法

32例患者均在臂叢阻滯麻醉下進行手術(shù),經(jīng)后正中切口進入,先顯示尺神經(jīng)給充分游離并妥善保護,經(jīng)尺骨鷹嘴關(guān)節(jié)外斜形截骨24例,經(jīng)肱三頭肌腱舌狀切開入路8例。顯露肱骨髁間骨折后,先以松質(zhì)骨拉力螺釘固定肱骨滑車和肱骨小頭骨折,使其由髁間骨折變?yōu)轺辽瞎钦?再復(fù)位肱骨髁上骨折,將2塊重建鋼板充分塑形后,貼附于肱骨內(nèi)、外上髁及骨干上固定,肱骨髁間骨折通過鋼板用松質(zhì)骨螺釘固定。……