切开复位解剖型钢板内固定治疗肱骨远端骨折

目的]探讨采用切开复位解剖型钢板（“Y”形）内固定治疗肱骨远端骨折的临床疗效。方法]2001年2月-2006年4月采用切开复位解剖型钢板（“Y”形）内固定治疗肱骨远端骨折共22例，采用尺骨鹰嘴截骨方法显露肱骨远端及关节面骨折者11例，采用肱三头肌舌形瓣方法显露骨折者11例。术后常规中药熏洗、CPM机训练、手法等综合治疗。结果]22例患者随访时间均超过1a，平均28个月（13—32个月），骨折全部愈合，平均愈合时间为5．7个月（4～10个月），根据Mayo肘关节功能评估指数，结果：优9例（40．9％），良7例（31．81％）。结论]切开复位解剖型钢板（“Y”形）内固定治疗肱骨远端骨折，固定可靠，为术后早期进行功能锻炼创造了条件；术后早期开始个体化患肢功能锻炼，结合中药熏洗、CPM训练、手法等方法可获得满意疗效。

Treatment of fractures of distal humerus with open reduction and anatomical plate internal fixation

Objective]To investigate the treatment of fractuees of distal end of humerus with open reduction and internal fixation with anatomical plate.Method]From February 2001 to April 2006,open reduction and anatomical plate internal fixation were performed in 22 cases with distal end of humerus fracture,of which olecranon osteotomy approach was carried out in 11 while musculus triceps brachii linguiform flap approach in other 11.All the patients received combined therapy including fumigation and rinsing with Chinese herbs,CPM(continuous passive motion) and manipulation.Result]All the cases were followed up for 13 to 22 months.All the fractures got union.The postoperative elbow functions were excellent in 9 cases,good in 7 cases according to Mayo standards.The satisfactory rate was 72.71%.Conclusion]Open reduction and internal fixation with anatomical plate can provide stable fixation and allow early postoperative elbow functional training in treatment of distal humerua fracture.Good clinical results can be achieved using fumigation and rinsing with Chinese herbs,CPM and manipulation after operation.