铰链式外固定支架辅助内固定治疗陈旧性肱骨远端B型骨折

目的 探讨采用铰链式肘关节外固定支架辅助内固定治疗陈旧性肱骨远端B型骨折的疗效.方法 2004年1月至2007年4月收治11例陈旧性肱骨远端B犁骨折患者,受伤至手术时间1.5～6.0个月(平均3.1个月),采用铰链式肘关节外固定支架辅助切开复位内固定进行治疗.根据Mavo肘关节功能评分标准对其疗效进行评定.结果 11例患者术后获10～18个月(平均12.5个月)随访.骨折临床愈合时间3.5～6.0个月,平均4.6个月.患者肘关节经功能锻炼后平均活动范围:伸直19.4°±6.5°,屈曲124.2°±11.3°;前臂旋前72.8°±5.4°,旋后67.6°±7.3°.按照Mayo肘关节功能评分标准:由术前(52.4±7.6)分上升至(85.7±9.3)分,差异有统计学意义(t=9.161,P=0.000);其中优5例,良4例,可2例.结论 采用切开复位内同定治疗陈旧性肱骨远端B型骨折,术后在铰链式外固定支架辅助下活动肘关节,早期进行功能锻炼,有利于肘关节功能的恢复,疗效满意.

Old distal humeral fractures of type B treated with hinged external fixators in combination with internal fixation

Objective To evaluate the hinged external flxator in combination with internal fixation for treatment of old type B fractures of the distal humerus.Methods Eleven cases of old type B fractures of distal humerus treated in our department were studied retrospectively.They were treated with hinged external fixators in combination with internal fixation and evaluated according to Mayo elbow performance scores.Results All the patients were followed up for 10 to 18(mean, 12.5)months.The mean union time was 4.6(range, 3.5 to 6.0)months.The final range of flexion to extension of the elbow was 19.4°±6.5° to 124.2°±11.3°.The final ranges of pronation and supination were 72.8°±5.4° and 67.6°± 7.3°.By Mayo elbow performance scores, the post-operative functional outcome of the elbow was excellent in 5 patients, good in 4, and fair in 2.Conclusion The old type B fractures of distal humerus can be effectively treated with hinged external fixators in combination with internal fixation, for early rehabilitation and restoration of the elbow function can be facilitated.