经尺骨鹰嘴截骨双钢板内固定治疗肱骨髁间严重粉碎性骨折

目的：探讨经尺骨鹰嘴截骨双钢板内固定治疗肱骨髁间严重粉碎性骨折的手术方法及疗效。方法：采用经尺骨鹰嘴截骨双钢板内固定治疗肱骨髁间严重粉碎性骨折30例，男19例，女11例；年龄21-62岁，平均42．3岁。按AO／ASIF分类：C2型17例，C3型13例。21例内外侧均采用重建钢板，9例外侧采用重建钢板，内侧采用1／3管形钢板。结果：术后随访6个月-3年，平均1．5年。骨折愈合时间3～6个月，平均4个月。无骨不连、骨化性肌炎、迟发性尺神经受压、内固定失效等并发症。按Aitken—Rorabeck标准评分系统对其肘关节功能评定，优16例，良10例，可2例，差2例。结论：手术解剖复位重建肘关节稳定，术后早期功能锻练，是肘关节功能恢复的重要因素，经尺骨鹰嘴截骨是治疗肱骨髁间严重粉碎性骨折较好入路。

Treatment of severely comminuted fractures of humeral intercondylar through approach of osteotomy olecranon with double-plate internal fixation

Objective: To explore surgical management and the effects of surgical treatment of severely comminuted fractures of humeral intercondylar through approach of osteotomy olecranon with double-plate internal fixation. Methods: Thirty patients of severely comminuted fractures of humeral intercondylar were treated by double-plate internal fixation through osteotomy olecranon. There were 19 males and 11 females,with an average age of 42.3 years ranging from 21 to 62. According to AO/ASIF classification,there were 17 cases of type C2 and 13 of C3. Twenty-one cases were applied with reconstructive plate medially and laterally,9 cases were applied with reconstructive plate laterally and 1/3 tubular plate medially. Results: All patients were followed-up for 6 months to 3 years(means 1.5 years). The complications such as bone defect, ossifying myositis,tardive ulnar nerve compression,internal fixation fail were no occurenced. According to Aitken-Rorabeck scale the function of the elbow showed excellent in 16 cases,good in 10,fair in 2 and poor in 2. Conclusion: Anatomical reduction surgically reconstructed stabilization of the elbow and early active rehabilitation are crucial factors of functional rehabilitation of the elbow. The technique of osteotomy olecranon with double-plate internal fixation for treatment of severely comminuted fractures of humeral intercondylar is a good approach.