经尺骨鹰嘴截骨入路双钢板治疗肱骨髁间骨折.DOCVIP

临床医学论文-经尺骨鹰嘴截骨入路双钢板治疗肱骨髁间骨折 【摘要】? 探讨经尺骨鹰嘴截骨入路应用肱骨内、外髁解剖钢板治疗肱骨髁间骨折的方法和临床疗效。［方法］2002年7月～2006年3月采用经尺骨鹰嘴截骨入路结合肱骨内、外髁解剖钢板治疗肱骨髁间骨折26例，男19例，女7例；年龄15～46岁，平均35岁。按照Riseborough和Radin的分类方法，Ⅱ型6例，Ⅲ型18例，Ⅳ型2例。［结果］术后25例骨折复位满意，1例复位稍差，无切口感染，1例术中牵拉损伤尺神经，22例获得随访，时间6～19个月，平均13. 5个月。尺神经损伤恢复，骨折全部愈合，无内固定松动及断裂，愈合时间14～24周，平均17周。根据改良的Cassebaum评分系统评价肘关节功能，其中优5例，良13例，可3例，差1例，优良率81. 8％。［结论］经尺骨鹰嘴截骨入路显露骨折充分，肱骨内、外髁解剖钢板固定肱骨髁间骨折牢固可靠，能有效的防止骨折不愈合，并可满足患者早期进行关节功能锻炼。 【关键词】? 肱骨髁间骨折 内固定 治疗效果 ??? Abstract：［Objective］To explore the surgical management and its results of intercondylar fracture of humerus through approach of osteotomy of olecranon (AOO) with dual anatomical steel plate DASP.［Method］From July 2002 to March 2006,26 patients of intercondylar fracture of humerus were treated surgically through AOO, and the fracture was reduced and fixed with DASP. The patients were 19 males and 7 females with a mean age of 35 years (range 15～46 years), According to Riseborough and Radin classification, type Ⅱ fracture was found in 6 cases, type Ⅲ in 18, type Ⅳ in 2. Early rehabilitation exercises was taken.［Result］Twentyfive fractures were satisfactory reduced but one not too good, none had incision infection, injuries of the ulnar nerve. Twentytwo patients were followed up from 6 months to 19 months (average 13.5 months), of these 22 patients, all the osteotomies healed in 17 weeks averagely(range 14～24 weeks) and the injuried ulnar nerve recovered completely. The function of the elbow (according to Cassbaum scale) showed excellent in 5 cases,good in 13, fair in 3 and poor in 1. the goodexcellent rate was 81.8%.［Conclusion］The technique of DASP for the treatment intercondylar fracture of humerus through transolecranon approach offers many advantages, such as sufficient exposure easy to get anatomical reduction, stable fixation and earlier exercise. ??? Key words：intercondylar fractures of humerus;??? internal fixation;??? effect ??? 作者简介：兰玉平(1969-)，男，重庆合川人，副主任医师，医学学士，研究方向：创伤骨科、关节外科，(电话(电子信箱)Lanyupi