肱骨远端C型骨折术后伸肘功能丢失原因分析

目的探讨采用经肱三头肌两侧入路内固定治疗肱骨远端C型骨折伸肘功能丢失的可疑因素。方法自2002年4月至2008年12月采用经肱三头肌两侧入路双钢板内固定治疗肱骨远端骨折30例,其中男8例,女22例;年龄12～80岁,平均41.4岁。按AO肱骨远端骨折分型标准评价,其中C2型12例,C3型18例（其中C3.1型11例,C3.2型4例,C3.3型3例）。结果 30例获得12～40个月随访,平均26个月。参照HSS肘关节评分标准评价术后功能,优11例,良13例,可2例,差4例,优良率80%（肘关节屈伸范围平均为18°～114°）。结论采用经肱三头两侧入路治疗肱骨髁间骨折,缩短手术操作时间,解剖重建冠状窝及滑车旋转轴,清理肘后肱三头肌下机化组织,早期功能锻炼,可以减少伸肘功能丢失。

To Investigate of Risk Factors of Extension Elbow Joint Dysfunction with Bilateral Approach Treated the Type-C Fractures of the Distal Humerus

Objective To investigate about risk factors of extension elbow joint dysfunction with bilateral approach treated the type-C fractures of the distal humerus.Methods From April 2002 to December 2008,a total of 30 cases of the complex fractures of the distal humeral were treated with bilateral approach through triceps brachii and open reduction and double plate internal fixation.There are 8 males and 22 females,with an average age of 41.4（12～80 years）.According to AO classification：there are 12 cases of type C2,18 cases of type C3（11 cases of type C3.1,4 cases of type C3.2,3 cases of type C3.3）.Results 30 cases were followed up for 12 to 40 months,averaged 26 months.Fracture union was obtained in all the patients.According to HSS score,excellent in 11 cases,good in 13,fair in 2 and poor in 4.rate of the function of the hip joint was 80%（average motion rom：18°～114°）.Conclusion With the bilateral approach through triceps brachii treated Type-C fractures of the distal humerus,reduce the operation time,reconstructing the important anatomical structures,early rehabilitation,that decrease complications of extension elbow joint dysfunction.