双柱固定原则在骨质疏松性AO 13C型骨折的临床应用和疗效分析

目的 运用双柱固定原则,手术治疗AO 13C型骨质疏松性骨折,评价患者肘关节重建情况及其功能。方法对本院骨科自2008年1月至2017年12月期间治疗的54例AO 13C型骨质疏松性骨折的患者进行回顾性分析,均采用切开复位肱骨远端解剖型LCP双钢板固定治疗。本组患者男21例,女33例;平均年龄(65.4±5.8)岁;根据AO/ASIF分型,13C1型21例,13C2型27例,13C3型6例;受伤至手术时间平均(7.9±1.6)d。用Mayo Clinic肘关节功能评分标准来评估手术疗效。结果 平均随访时间(20.8±2.1)个月。平均手术时间103.5min;平均骨折愈合时间(13.5±1.0)周。术后伸肘平均9.4°±5.6°,屈肘平均108.1°±7.4°,活动范围平均99.2°±10.3°。Mayo Clinic肘关节功能评估平均(84.7±8.1)分;优20例,良29例,中5例,差0例。结论 运用双柱固定原则,使用解剖型LCP治疗AO 13C型骨质疏松性骨折临床效果优良,肘关节功能恢复良好。

Surgical treatment of osteoporotic AO 13C fracture with double column fixation principle: A retrospective study

Objectives To evaluate the function of elbow joint after surgical treatment, the osteoporotic distal humeral fractures were treated using anatomical distal humeral locking compression plate with double column fixation principle. Methods According to the AO/ASIF classification, 13C fractures were enrolled in our retrospective study. From January 2008 to December 2019, 54 patients suffering osteoporotic distal humeral fracture were treated with open reduction and internal fixation using anatomical distal humeral locking compression plate with principle of triangular stability in our department. The average age of 54 patients (21 males and 33 females) was (65.4±5.8) years. The average time from injury to operation was (7.9±1.6) d. Early functional exercises were performed on the first postoperative day. Mayo clinic elbow performance score was used to evaluate the affected elbow function postoperatively. Results The average follow-up time was 20.8 months. The average surgical time was 103.5 min. The average fracture healing time was (13.5±1.0) weeks. To the last follow-up time, the average active extension degree of affected elbow joint is 9.4°±5.6°, and the average active flexion degree is 108.1°±7.4°. The average range of motion of affected elbow joint is 99.2°±10.3°. According to Mayo Clinic elbow performance score, the average score was (84.7±8.1), and the result was excellent in 20 cases, good in 29 cases, fair in 5 cases and no poor case. Conclusion With principle of double column fixation and anatomical distal humeral locking compression plates, rigid stabilization and bone healing of osteoporotic distal humeral fracture can be achieved. After appropriate early rehabilitation, the function of elbow joint is quite well in average 20 months follow up. Open reduction and internal LCP fixation is an effective method in treating osteoporotic distal humeral fracture.