肱骨远端冠状面剪切骨折的手术治疗效果研究Studyonthesurgerical.PDF

肱骨远端冠状面剪切骨折的手术治疗效果研究 余　敏，丑　克 （长沙市中心医院关节外科，长沙，410004 ） 余敏，E-mail: docyummy@126.com 摘要目的：研究Herbert钉固定治疗肱骨远端冠状面剪切骨折的治疗效果。方法： 2010年10月至2013年9月，采用Herbert钉固定治疗8例肱骨远端冠状面剪切骨折 患者。按Dubberley分型，Ⅱ型3例，Ⅲ型5例。均为闭合性骨折，无合并血管及 神经损伤情况。术后3个月测量患者肘关节活动度及对肘关节功能进行Broberg- Morrey评分。结果：所有患者术后伤口愈合良好，疼痛症状好转消失，无感染 情况，骨折对位良好，稳定，内固定无松动，无神经损伤并发症。术后3个月肘 关节活动度平均87.5°，Broberg-Morrey评分平均89，均为优良。结论：使用 Herbert钉固定治疗肱骨远端冠状面剪切骨折既能够对骨折块进行加压，又不会 影响肘关节的运动轨迹，肘关节功能恢复满意，手术效果良好。 关键词：肱骨远端；冠状面；剪切骨折 Study on the surgerical treatment and outcome of distal humeral coronal shear fractures [Abstract] Objective To investigate the treatment and outcome of distal humeral coronal shear fractures by using Herbert screw. Methods From October 2010 to September 2013, 8 patients with coronal shear fracture of distal humeral were surgical treated and fixed with Herbert screws. According to Dubberley classification, type II 3 cases; type III 5 cases. All are Closed fracture, without Vascular and nerve injury. 3 months after surgery, measure the range of movement and Broberg-Morrey score of elbow. Result all wound are good healing, pain symptoms disappeared, without infection. The reduction is good, and fracture are stable, without internal fixation loosening, and no neurological complication. 3 months after surgery, the average range of movement of elbow is 87.5°; and the average Broberg-Morrey score of is 89, which is excellent. Conclude: To treat the coronal shear fractures of the distal humerus by using the Herbert screw can obtain ideal surgerical effect such as compressing the fracture without influence the trail of elbow, satisfied recovery of elbow function. [Key words] distal humeral; coronal; shear fracture 　　肱骨远端骨折在临床上是很常见的损伤，但累及肱骨滑车冠状面及肱骨小 头的剪切骨折则不常发生，临床较为少见，研究发现约占肘部骨折的1% ［1］。 ［2 ］ 依据骨折的不同分型，其手术方式、切口选择及固定方法多种多样 ，目前