双钢板治疗C3型肱骨干骨折的临床分析

目的探讨双钢板治疗C3型肱骨干骨折的临床疗效。方法对收治的12例C3型肱骨干骨折的患者，术中应用双钢板内固定治疗。记录本组患者的损伤因素、手术时间、术中出血、术前和术后影像学检查（X线或CT），采用Mayo肘关节功能评分、Constant-Murley肩关节功能评分和手臂肩残疾问卷表评定术后患肢功能。结果12例患者均顺利完成手术，手术时间41~96（62±16）min，术中出血量80~420（162±12）ml，术后随访12~36（21.0±3.2）个月，骨折愈合时间2~6（3.2±1.1）个月。末次随访Mayo肘关节功能评分89~95（93.5±3.8）分，Constant-Murley肩关节功能评分78~95（91.6±3.6）分，手臂肩残疾问卷表得分4.17~22.5（15.0±3.0）分。1例桡神经损伤(术前已存在)，术中探查完整性存在，未作特殊处理，4个月后神经功能恢复。结论双钢板治疗C3型肱骨干骨折，手术技术简单，固定牢固，有利于患者早期开展功能锻炼，降低并发症发生率，临床疗效良好。

Clinical efficacy of dual-plate in treatment of C3 type humeral shaft fractures

Objective To evaluate the clinical efficacy of dual plating in treatment of C3 type humeral shaft fracture. Methods Twelve patients with severely comminuted humeral shaft fractures (OTA, C3) were treated with dual plate in our hospital from January 2010 to March 2015. The clinical data including the injury factors, operation time, intraoperative bleeding, imaging examinations (X-ray or CT) were documented, and the functional recovery was evaluated with Mayo Elbow Performance score(MEPS), Constant-Murley score, disabilities of the arm, shoulder, and hand (DASH). Results The operations were successful in all 12 patients. The average operation time was (62±16)min, the average intraoperative blood loss was (162±12)ml, the mean follow-up was (21.0±3.2) months, the average healing time of fracture was (3.2±1.1) months. One patient who had symptoms ofradial nerve injury before surgery achieved full recovery after surgery. At final follow up, the function of shoulder, elbow and wrist in operated limbs was all satisfactory with an average MEPS score of 93.5±3.8, Constant-Murley score of 91.6±3.6 and DASH score of 15.0±3.0. Conclusion Internal fixation with dual-plate is an effective treatment for type C3 humeral shaft fractures withadvantages of practicable technique, stable fixation, early and aggressive range of motion and early functional recovery, and no significant complications.