双重建钢板内固治疗肱骨髁间骨折.pdfVIP

摘 要 双重建钢板内固定治疗肱骨髁间骨折 研究生：郭欣涛 导师：田禾 副教授 摘 要 目的：探讨应用双重建钢板内固定治疗肱骨髁间骨折的疗效及分析影响术后肘 关节功能恢复的因素。方法：2003年1月～2008年3月手术治疗肱骨髁间粉碎性骨折 23例，男14例，女9例，年龄13～58岁，平均36.2岁。左侧9例, 右侧14例。按照AO/ASIF 分类：C1型6例，C2型9例，C3型8例。其中开放性骨折2例，合并桡神经损伤5例， 尺神经损伤4例。所有病例行后路经尺骨鹰嘴截骨或经肱三头肌两侧入路，使用双重 建钢板内固定。术后尽早主动行肘关节功能锻炼。结果：23例随访8～38个月，平均 14.6个月，骨折均Ⅰ期愈合。术后伤口感染1例，经伤口换药3周愈合；桡神经牵拉损 伤1例，经神经营养药物治疗后恢复。根据Cassebaum法评分，优8例，良11例，可4 例，优良率82.6 ％。结论：双重建钢板内固定治疗肱骨髁间骨折是目前治疗肱骨髁间 骨折的较好方法。骨折粉碎程度及软组织损伤的严重程度、有效复位及内固定、早 期功能锻炼等是影响肘关节功能恢复的主要因素。 关键词：肱骨髁间骨折；双重建钢板；内固定术；肘关节 —1— 新疆医科大学医学硕士学位论文 Dual reconstruction plate fixation treatment of humeral condylar fracture Postgraduate:Guo Xintao Supervisor: Prof.Tian He Abstract Objective: To investigate the application of dual-reconstruction plate fixation of humeral condylar fracture analysis of the efficacy and impact on functional recovery after elbow factors.Method: From January 2003 to March 2008,23 cases (male 14, female 9) of humeral intercondylar fractures were reviewed, with an average age of 36.2 years (ranged,13～58 years).Left elbow:9 cases;right elbow:14 cases.According to AO/ASIF classification,type C1 ∶6,type C2 ∶9, and type C3 ∶8,2 cases of all were open fractures. Posterior operating approach of elbow: trans-olecranon osteotomy or trans-triceps-side approach and internal fixation by standard method of double plates were performed in all cases.The patients began the active training of elbow joint as soon as possible postoperatively.Result: Twenty-three cases were followed up for 8～38 months and the average time was 14.6 months.Bone union was obtained in all cases.One case compli