平行加压钢板内固定治疗肱骨远端C型骨折的疗效观察

 目的 分析平行加压钢板内固定治疗肱骨远端C型骨折的临床疗效。方法 回顾分析2007-06至2014-08收治的肱骨远端C型骨折65例资料。按照肱骨远端骨折AO分型:C₁型24例,C₂型32例,C₃型9例;手术选用肱三头肌-肘肌瓣入路;采用平行加压钢板内固定,强调最大限度地固定远端骨折块、并在骨折髁上水平进行加压的治疗原则。结果 65例均得到随访,随访时间9～18个月,平均12个月;骨折愈合时间8～20周,平均16周;康复使用CPM机进行有计划的肘关节锻炼;按照MEPS肘关节功能评分标准:优20例,良37例,可6例,差2例,总优良率87.6%。并发异位骨化(HO)2例,创伤性关节炎2例,尺神经牵拉伤2例,伤口轻度感染延期愈合3例。结论 平行加压钢板内固定治疗肱骨远端C型骨折,提供了良好的力学稳定结构,使骨折内固定坚固、可靠,允许肘关节早期功能康复练习,肘关节功能恢复较为满意。

Clinical observation on internal fixation for treatment of type-C distal humerus fracture with parallel compression plate

Objective To analyze the clinical effect of internal fixation for treatment of type-C distal humerus fracture with parallel compression plate. Methods Clinical data of 65 patients with type-C distal humerus fracture were analyzed retrospectively from June 2007 to August 2014. According to the AO classification, there were 24 cases of type C₁, 32 cases of type C₂, and 9 cases of type C₃. Operation of triceps-anconeus flap approach was selected. Internal fixation with parallel compression plate,furthest fixation of the distal fracture fragments and compressive at supracondylar level were the treatment principle. Results All patients were followed up. The follow-up time was 9-18 months, averaged 12months; healing time was 8-20 weeks, average 16 weeks. CPM was used for elbow joint rehabilitation training designedly. We got the excellent result in 20 cases, good in 37, fair in 6 and poor in 2 according to Mayo Elbow Performance Scores (MEPS), the excellent and good rate was 87.6%. Heterotopic ossification was found in 2 cases, traumatic arthritis in 2 cases, ulnar nerve stretch injury in 2 cases, slight wound infection and delayed healing in 3 cases. Conclusions Internal fixation for treatment of type-C distal humerus fracture with parallel compression plate provides excellent mechanical stable structure, dependable fastness, reliable early functional exercise, and satisfactory functional recovery in elbow joint.