经肱三头肌后侧切开入路及双柱解剖钢板治疗肱骨远端骨折

目的探讨经肱三头肌切开入路及肱骨远端解剖形双钢板治疗肱骨远端复杂骨折的临床效果。方法选择经肘关节肘后正中切口肱三头肌劈开入路,双侧解剖钢板内固定治疗16例肱骨远端骨折。根据AO分型,A22例,A31例,B12例,B23例,C13例,C24例,C31例。结果 16例患者均获得随访,随访时间10～36个月,平均16.6个月。骨折全部愈合。按照Cassebaum评分系统对肘关节功能进行评价：优10例,良4例,可2例,总优良率为87.5%。术后未出现伤口感染和桡神经牵拉伤,亦无尺神经炎表现。结论经肘肱三头肌切开入路采用两侧解剖钢板治疗肱骨远端骨折,既有充分的显露,又对软组织损伤较小,既能达到精确的关节面复位,坚强的固定,又能进行早期的功能锻炼,取得了良好的疗效。

Anatomy-shaped double-plating fixation via triceps brachii split approach in treatment of distal humeral fractures

Objective To investigate clinical efficacy of anatomy-shaped double-plating fixation via triceps brachii split approach in treatment of distal humeral fractures.Methods From June 2006 to October 2010,16 cases of distal humeral fractures were treated by open reduction via triceps brachii split approach and anatomy-shaped double-plating fixation according to the classification of Association for the Study of Internal Fixation(AO/ASIF),2 cases were type 13-A2,1 as type 13-A3,2 as type 13-B2,3 as type 13-B2,3 as type 13-C1,4 as type 13-C2,and 1 as type 13-C3.The function of the elbow was evaluated by Cassebaum scoring system.Results 16 cases were followed up for 10 to 36 months as an average of 16.6 months.All of Fractures were healed.According to Cassebaum scoring system,the results were excellent in 10 cases,good in 4 cases,and fair in 2 case;the excellent and good rate was 87.5%.Wound infection and radial nerve stretch injury was not found.All of cases had no ulnar neuritis.Conclusion It is a good effect that distal humeral fractures are treated by anatomy-shaped double-plating fixation via triceps brachii split approach,which has the advantages of sufficient expose,less soft tissue damage,precise articular surface reduction,rigid internal fixation and early functional exercise.