内外侧新型解剖型接骨板治疗肱骨髁间骨折

目的 介绍内外侧新型解剖型接骨板治疗肱骨髁间骨折的手术方法和疗效.方法 自2007年3月至2009年9月手术治疗肱骨髁间骨折35例,男27例,女8例;年龄21～87岁,平均46.2岁;左侧21例,右侧14例.骨折按照AO分型:C1型19例,C2型11例,C3型5例.经肱三头肌两侧入路或尺骨鹰嘴"V"形截骨2路,采用肱骨远端解剖接骨板治疗25例,采用肱骨远端解剖锁定接骨板治疗10例,术后早期积极进行功能锻炼.结果 所有患者术后获得6～24个月(平均14个月)随访,均获骨性愈合,术后未发生感染、内固定松动、异位骨化等并发症.肘关节平均屈伸81°(9～131°),屈曲110°(66～135°),伸直22°(0～75°).Mayo肘关节功能评分平均92分(62～100分),其中优20例,良10例,可4例,差1例,优良率为85.7%.疗效差的1例为C3型骨折合并颅脑外伤,术后未能及早行功能锻炼,造成肘关节僵硬.结论 采用内外侧新型解剖型接骨板治疗肱骨髁间骨折能获得坚强固定,有利于早期肘关节功能锻炼从而获得优良治疗效果.

Treatment of humeral intercondylar fractures with bilateral orthogonal precontoured anatomical plates

Objective To introduce a new type of bilateral anatomical plates used for treatment of intercondylar fractures of humerus. Methods From March 2007 to September 2009, we treated 35 patients with intercondylar fracture of humerus with distal anatomical humeral plates(Zimmer) and distal anatomical humeral locking plates (Synthes). By AO classification, there were 19 elbows of C1, 11 elbows of C2 and 5 elbows of C3. The surgical approach was either bilateral or via olecranon process of ulna. Early mobilization was initiated after surgery. Results All the patients were followed up with a mean follow-up period of 14 months. No non-union was discovered. According to Mayo elbow performance score (MEPS), 20cases were excellent, 10 were good, 4 were fair and one was poor. Conclusion Treatment of an intercondylar humeral fracture with bilateral anatomical plates can gain immediate stabilization which facilitates early mobilization of the elbow.