3种手术方法治疗肱骨髁间骨折的比较

目的比较肱骨髁间骨折3种手术治疗的临床疗效。方法东莞市樟木头人民医院2002年6月至2009年6月手术治疗肱骨髁间骨折83例,其中用克氏针固定30例,单重建钢板加拉力螺钉固定19例,双重建钢板固定34例。结果所有患者术后随访3个月～1年,根据改良Cassebaum评分法：双重建钢板固定优20例,良11例,可3例,优良率91.2%;单重建钢板加拉力螺钉固定优8例,良7例,可4例,优良率78.9%;克氏针固定优2例,良8例,可14例,差6例,优良率33.3%。3组优良率相比,差异有统计学意义（P〈0.01）。结论采用双重建钢板固定进行早期解剖复位,坚强固定加早期功能锻炼有利于肢体功能恢复,优于其他2种方法。

A Comparison of Three Methods for Treating Intercondylar Humeral Fractures

ObjectiveTo compare the clinical effects of 3 surgical methods on intercondylar humeral fractures.MethodsFrom June 2002 to June 2009,83 patients with intercondylar fractures of the humerus were treated surgically.The subjects consisted of 30 patients treated with K-wire fixation,19 treated with single-screw reconstruction plate and lag screw fixation,and 34 treated with double reconstruction plate fixation.ResultsAll the patients were followed up for 3-12 months.According to Cassebaum scoring system,the results of double reconstruction plate fixation for intercondylar humeral fractures were rated as excellent in 20 patients,good in 11 and fair in 3,with a excellent and good rate of 91.2%.The results of single-screw reconstruction plate and lag screw fixation were rated as excellent in 8,good in 7 and fair in 4,with a excellent and good rate of 78.9%.The results of K-wire fixation were rated as excellent in 2,good in 8,fair in 14,and poor in 6,with a excellent and good rate of 33.3%.The differences in excellent and good rate were significant among the 3 methods（P0.01）.ConclusionDouble reconstruction plate for early anatomical reduction and rigid fixation with early functional exercise is conducive to the recovery of limb function.