带轴肘关节外固定支架在治疗复杂肘关节损伤中的应用

目的　介绍应用带轴肘关节外固定支架辅助内固定治疗复杂肘部损伤的方法及初步疗效。方法　按损伤类型行简单骨折内固定辅以带轴外固定支架固定骨折及牵引关节 ,术后及时作主被动功能锻炼。结果　自 1 999年 1 2月～ 2 0 0 3年 5月采用上述方法治疗各类复杂肘部损伤 1 5例 ,有 1 4例获得平均 1 7 7个月的随访 ,总优良率为 78 5 % ,骨折平均愈合时间 1 4 7周。有 2例发生支架螺钉周围皮肤伤口渗液 ;1例尺神经感觉功能减退 ,术后 5个月恢复。结论　应用带轴肘关节外固定支架辅助内固定治疗复杂肘部损伤 ,能提高内固定的强度 ,提供肘关节侧方稳定性 ,能使肘关节进行早期功能锻炼 ,有利于骨折和韧带的愈合 ,促进肘关节功能的恢复

Application of the Hinged External Fixator as Auxiliary Means in Treatment of Complex Injuries about the Elbow

Objective To introduce the hinged external fixator as an auxiliary means to internal fixation in treatment of complex injuries about the elbow.Methods The fractures and dislocations were reduced and fixed with internal fixation and enhanced and distracted by the hinged external fixator.The joints were passively and then actively motivated soon after operation.Results From Dec.1999 to May 2003,15 cases of various types of complex elbow injuries were treated with the above method.After an average follow-up of 17 7 months,the overall satisfaction rate reached 78 5% in spite of one lost case.The average fracture union time was 14 7 weeks.Complications included pin-site inflammation and exudation in 2 cases and ulna paresthesia in one case which recovered 5 months later.Conclusion The protocol of internal fixation in combination with the hinged external fixator will enhance the strength of the internal fixation,help maintain lateral stability,facilitate early motion of the injured elbow which are helpful to fracture union,ligament repair and recovery of the joint function.