全肘关节置换治疗复杂肱骨间骨折疗效分析.docVIP

全肘关节置换治疗复杂肱骨髁间 骨折疗效分析 姜保国 教授 北京大学人民医院 [摘要] 目的 探讨肘关节置换术治疗复杂肱骨髁间骨折的疗效。方法 2005年8月～2006年4月，通过肘关节置换术治疗了3例复杂肱骨髁间骨折患者，1例为男性，38岁，伴有血友病性关节炎，2例为女性，年龄分别为66岁、82岁，伴有类风湿性关节炎。3例肱骨髁间骨折患者中的1例伴血友病关节炎和1例伴类风湿关节炎患者接受了一期肘关节置换，另一例伴类风湿关节炎的患者在行切开复位内固定手术失败后接受了肘关节置换术。3例患者均获得随访，随访时间3~10个月，以Mayo评分评估其肘关节功能。结果1例伴血友病关节炎的肱骨髁间骨折患者术后的Mayo评分为良（75分），2例伴有类风湿关节炎的肱骨髁间骨折患者中，内固定手术失败后接受肘关节置换的患者Mayo评分为良（85分），一期肘关节置换患者的Mayo评分为优（95分），3例肘关节置换患者近期随访未出现疼痛或假体松动。结论 对年龄偏大，骨质疏松明显，骨折粉碎难以复位和固定，关节毁损严重的老年肱骨髁间骨折患者，实施肘关节置换术可获得满意疗效。 [关键词] 肱骨髁间骨折；全肘关节置换术 Treatment effect of the complex humeral intercondylar fractures with total elbow replacement. Jiang Bao-guo, Zhang Dian-ying, Fu Zhong-guo. Departmnet of Orthopaedics and Traumatology, Peking University People’s Hospital, Beijing 100044, China [Abstract] Objective To discuss the treatment effect of complex humeral intercondylar fracture with total elbow replacement. Methods From August, 2005, to April, 2006, 3 cases of the complex humeral intercondylar fracture were treated with total elbow replacement, one case is male, 38 years old, associated with haemophilia arthritis, 2 cases are female, 66 and 82 years old differently, associated with rhuematoid arthritis. The patient associated with haemophilia arthritis and the patient, 66 years old, associated with rhuematoid arthritis, accepted primary total elbow replacement, another patient, 82 years old, associated with rhuematoid arthritis, firstly accepted open reduction and internal fixation, after the operation failed, she accepted total elbow replacement. 3 cases have been followed for 3 to 10 months, and were evaluated with Mayo elbow performance score . Results The patient associated with haemophilia arthritis rated as good（75 point）. Between 2 cases associated with rhuematoid arthritis, the patient whose open reduction and internal fixation failed rated as good(85 point), the patient who accepted primary total elbow replacement rated as excellent(95 point). No local pain or prothesis loosening occured among 3