改良肘后入路Y形钢板治疗肱骨髁部骨折

目的:探讨改良肘后正中纵行入路Y形钢板内固定治疗肱骨髁部粉碎性骨折的临床疗效。方法:23例肱骨髁部骨折(按AO/ASIF分类法:A3型10例,C1型6例,C2型4例,C3型3例),采用改良肘后正中纵行入路Y形钢板内固定,术后配合肘关节功能锻炼,早期应用非甾体类药物。结果:术后平均随访15个月,按Cassebaum标准进行肘关节功能评定:优17例,良4例,可2例,优良率91.3%。无血管神经损伤、内固定失败、骨化性肌炎、骨折畸形愈合、骨不连等发生。结论:改良肘后正中纵行入路Y形钢板内固定具有暴露安全充分、内固定可靠、术后并发症少的优点,可作为治疗肱骨髁部粉碎性骨折的首选。

Treatment of comminuted humeral condylar fracture with Y-shape plate fixation and modified intermedial-longitudinal approach of elbow

Objective:To investigate the outcome of comminuted humeral condylar fractures with(Y-shape) plate fixation and modified intermedial-longitudinal approach of elbow.Methods:Twenty-three patients with comminuted humeral condylar fracture were classified according to AO/ASIF,A_3 in 10 cases,C_1 in 6,C_2 in 4,C_3 in 3.The fractures were fixed with Y-shape plate through modified intermedial-longitudinal approach elbow.Following elbow joint functional exercises and taking no-steroid in the early stage.Results:All patients were followed up with average of 15 months.According to elbow joint functional standard of Cassebaum,17 case were excellent result,4 good and 2 fair.The rate of excellent and good was 91.3%.No injuries of blood vessel and nerve,failure of internal fixation,myositis ossificans,malunion,nonunion were found.Conclusion:Modified approach and Y-shape plate fixation has such advantages as sufficient exposure,reliable fixation,less complication,which may become the first selection for treating comminuted humeral condylar fractures.