经尺骨鹰嘴截骨入路钛板内固定治疗成人肱骨髁间骨折

目的讨论经鹰嘴截骨入路应用钛板治疗成人肱骨髁间骨折的疗效。方法采用手术治疗肱骨髁间骨折24例,根据Aomuller分型,C1型6例,C2型13例,C3型5例,均为闭合性骨折,合并尺神经损伤3例。均采用尺骨鹰嘴截骨入路切开、复位,根据骨折情况采用Y型钛板或双重建钛板固定,术后采用循序渐进方式肘关节功能锻炼。结果 24例患者均获得随访,骨折全部一期愈合,肘关节功能恢复均较满意。根据Cassebaum评分系统评价肘关节术后疗效:优18例,良12例,可4例,优良率83.3%。结论成人肱骨髁间骨折尽量早期手术,选用尺骨鹰嘴截骨术入路,选择适合的坚强内固定,可早期功能锻炼,肘关节功能恢复较为满意。

TREATING ADULTS' EEPITROCHLEAR FRACTURE BY THE INTERNAL FIXATION OF TITANIC SPLINTS DISSECTED THROUGH THE OLECRANAL OSTEOTOMY

Objective To discuss the therapeutic effect of treating adults’ epitrochlear fracture by the internal fixation of Titanic splints dissected through the olecranal osteotomy.Methods Operations were made on 24 patients to treat their epitrochlear fracture.According to Aomuller Classifying System,there were 6 cases for C1 type,13 cases for C2 type and 5 cases for C3 type.All cases belonged to closed fracture and involved 3 cubital nerve trauma.Each fracture wound was dissected and reducted from olecranal osteotomy.What’s more,each fracture got fixed internally by using Y-shape Titanic splints or double-built splints.After the operation,patients were encouraged to implement step-by-step elbow joint functional exercising.Results All 24 patients got their follow-up visits.Their fractures were found to heal well during the possible first stage.Moreover,their elbow joints recovered satisfactorily as well.Based on the Cassebaum Assessment System,the time came to the recovery of elbow joints functions was taken as the diagnostic criteria,18 cases got "excellent",12 cases got "fairly good" and 4 cases "not bad".The rate of excellence reached 83.3%.Conclusions Adults who suffer from epitrochlear fracture are encouraged to have an operation as soon as possible.By the internal fixation of Titanic splints dissected through the olecranal osteotomy,plus the early-stage exercising,the patients’elbow joints are able to recover quite satisfactorily.