经尺骨鹰嘴截骨入路双钢板治疗C型肱骨远端骨折

目的探讨经尺骨鹰嘴截骨入路，利用内、外侧双钢板治疗C型肱骨远端骨折的方法及疗效。方法2002年3月～2007年12月共采用经尺骨鹰嘴“V”型截骨入路，内、外侧双重建钢板治疗C型肱骨远端骨折29例，男17例，女12例，左18例右11例。年龄23～61岁，平均37．5岁，按AO／ASIF分型，C1型7例，C2型12例，C3型10例。其中开放性骨折3例，尺神经损伤2例，桡神经损伤1例。术后48小时开始功能锻炼。结果随访12～36个月，平均15．4个月。骨折及鹰嘴截骨处全部愈合。皮下感染3例，经换药3周后愈合，神经损伤在3月内均恢复。骨化性肌炎2例。按Cassebaum评分系统评价肘关节功能，优9例，良15例，可3例，差2例，优良率82．8％。结论经尺骨鹰嘴截骨入路可以充分显露肱骨远端，有利于解剖复位粉碎的关节面，内、外侧双钢板固定骨折块，牢固可靠，可满足肘关节早期功能锻炼。

Dual reconstructive steel plate for the surgical management of C type fracture of distal end of humerus through approach of osteotomy of olecranon

Objective To explore the surgical management and its results of C type fracture of distal end of humerus through approach of osteotomy ofolecranon with dual reconstructive steel plate. Method From March 2002 to De-cember 2007, 29 patients, 17 males and 12 females with a mean age of 37.5 years (range 23 ～ 61 years), of C type frac-ture of distal end of humerus were treated surgically through approach of"V" shape osteotomy of olecranon, and the frac-ture was reduced and fixed with dual reconstructive steel plate.. The fractures were located on left side in 18 and on fight side in 11. According to AO/ASIF classification, there were type C 1 7 cases, type C2 12 cases and type C3 10 cases,among them, 3 case were open fractures, 2 were ulnar nerve injury, 1 were radial nerve injury. Early rehabilitation exercises was taken within 48 h. Result 29 patients were followed up from 12 months to 36 months (average15.4 months), all the fractures and the osteotomy of olecranon healed well. The complications included 3 subcutaneous infection, which re-covered in 3 weeks with dressings, and the injuried nerve recovered completely in 3 months., and 2 were myositis ossifi-cans. The function of the elbow (according to Cassbaum scale) showed excellent in 9 cases, good inl 5, fair in 3 and poor in 2, and the excellent-good rate was 82.8%. Conclusion The technique of dual reconstructive steel plate for the treat-ment of type C fracture of distal end of humerus through trans-olecranon approach has many advantages, such as suffi-cient exposure, easy to get anatomical reduction, stable fixation and earlier exercise.