肘内外侧联合入路和肘后尺骨鹰嘴截骨入路治疗肱骨髁间骨折

目的:探讨肘内外侧联合入路和肘后尺骨鹰嘴截骨入路治疗肱骨髁间骨折的疗效及优缺点。方法:2012年10月至2016年5月,对18例肱骨髁间骨折患者进行手术治疗,男12例,女6例;年龄4~56岁,平均33.5岁。按AO分型:C1型3例,C2型8例,C3型7例。8例行肘关节内外侧联合入路,10例行尺骨鹰嘴截骨入路;所有患者术前排除神经、血管损伤。结果:18例患者获随访,时间12~26个月,平均15个月。患者伤口愈合良好,未发现异位骨化。按改良的Cassebaum肘关节功能评分:优14例,良3例,可1例。结论:根据骨折类型,选择合适的手术入路及固定方式,力求解剖复位、坚强固定,配合早期功能锻炼是肱骨髁间骨折手术取得成功、最终获得良好功能恢复的重要条件。

Treatment of intercondylar fracture of the humerus through internal and external elbow approach or elbow posterior olecranon osteotomy approach

Objective:To investigate the efficacy,advantages and disadvantages of internal and external elbow joint approach and olecranon osteotomy approach for the treatment of intercondylar fracture of humerus.Methods:From October 2012 to May 2016,18 cases of intercondylar fracture of humerus were treated by operation including 12 males and 6 females with a mean age of 33.5 years old (ranged from 4 to 56 years old);8 cases were operated by internal and external elbow joint approach,10 cases were operated by olecranon osteotomy approach. According to AO classification,3 cases were type C1,8 cases were type C2,7 cases were type C3. All patients were excluded from neurologic and vascular injuries.Results:All patients were followed up from 12 to 26 months with an average of 15 months. The incision healed well and no heterotopic ossification was found. According to the modified Cassebaum elbow function score,the result was excellence in 14 cases,good in 3 cases,fair in 1 case.Conclusion:According to the fracture type,the appropriate surgical approach and fixation were selected in order to get anatomic reduction. Rigid fixation,and early functional exercise is important condition for successful operation and satisfactory functional recovery in intercondylar fracture of the humerus.