应用组合式植骨内固定方法治疗肱骨髁部骨不连

目的:探讨改进的植骨内固定方法治疗肱骨髁部骨不连的临床效果。方法:本组12例,男5例,女7例;年龄16~59岁,平均32.5岁。4例并发神经损伤,肘关节平均屈伸活动度45°(10°~55°)。均应用组合式植骨 组合式内固定方法重建肱骨髁部。结果:12例均得到随访,时间6~48个月,平均26个月。术后12例均获得临床愈合,平均临床愈合时间为术后4.5个月(3.5~10.0个月)。所有病例术后疼痛均明显减轻,肘关节屈伸活动度明显改善。按照HSS肘关节评分标准,术前平均(57.16±1.75)分与术后平均(89.53±2.67)分比较,差异有显著性意义(t=16.317,P<0.01)。结论:组合式植骨 组合式内固定方法符合生物力学原理,真正实现肱骨髁部的解剖重建和多点位、多维空间的加压固定,同步实现骨愈合与关节功能康复,是治疗肱骨髁部骨不连的有效方法。

Application of composite bone graft and internal fixation in the treatment of nonunion of the humeral condylar fracture

Objective: To evaluate the clinical efficacy of a new surgical treatment of nonunion of the humerus condyle.Methods: Among 12 patients in the study,7 patients were female and 5 patients were male,ranging in age from 16 to 59 years,with an average of 32.5 years.Four patients were combined with nerve injuries.The flexion-extension arc of the motion of the elbow joint ranged from 10° to 55° (mean 45°).All the patients were treated with composite bone graft and internal fixation.Results: All the patients were followed-up,ranged from 6 to 48 months,with an average of 26 months.The mean healing time averaged 4.5 months after operation (range,3.5 to 10.0 months).The pain relieved and flexion-extension arc improved after operation.According to the Hospital for Special Surgery scoring system,preoperative and postoperative mean score were 57.16±1.75 and 89.53±2.67, respectively(t=16.317,P<0.01).Conclusion: The composite bone graft and internal fixation meets to biomechanics principle,which can be selected to obtain precise anatomic reconstruction and compression fixation in three dimensions of the humeral condylar region.This method can also promote bone union and rehabilitation of articular function.This is an effective method for the treatment of nonunion of the humeral condyle.