不同手术入路治疗青壮年肱骨远端C型骨折的疗效研究

发布时间：2018-01-21 00:25

本文关键词： 肱骨远端骨折肱三头肌舌瓣尺骨鹰嘴截骨　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：分析比较经肱三头肌舌瓣入路与尺骨鹰嘴截骨人路治疗青壮年肱骨远端C型骨折的临床疗效。方法：回顾性分析2010年9月至2014年3月,于新疆医科大学第六附属医院住院的45名青壮年患者,采用肱三头肌舌瓣入路或尺骨鹰嘴截骨入路重建钢板双柱固定治疗。患者术后行功能锻炼。分析比较两组：(1)手术时间,(2)骨折愈合情况,有无畸形愈合、骨不连发生,有无异位骨化及其他并发症,(3)肘关节活动度,(4)Mayo肘关节功能评分(MEPS),(5)肱三头肌肌力。结果：45名患者均得到随访,时间6-24个月,平均12.7个月。手术时间及愈合时间两组比较无统计学差异；两组均未见骨不连、内固定物失效及松动,未见肘关节僵直,两组术后并发症的发生率比较,无统计学差异；舌形瓣入路组患者术后肘关节活动度为77.00±11.93,低于尺骨鹰嘴截骨入路组患者的96.11±10.32,有统计学差异(P0.05)；舌形瓣入路组患者术后MEPS为74.93±9.12,低于尺骨鹰嘴截骨入路组患者的83.15±8.52,有统计学差异(P0.05)；两组肱三头肌肌力比较,无统计学差异。根据AO分型分层比较显示,尺骨鹰嘴截骨入路治疗C2、C3型骨折疗效优于肱三头肌舌瓣入路,而C1型两组疗效无统计学差异。结论：尺骨鹰嘴截骨入路患者术后可早期行功能锻炼,并发症未见明显增加,有利于肘关节功能的恢复。
[Abstract]:Objective: to compare the clinical effects of transtriceps lingual flap approach and olecranon osteotomy approach in the treatment of type C fracture of distal humerus in young adults. Methods: from September 2010 to March 2014. 45 young and adult patients hospitalized in 6th affiliated Hospital of Xinjiang Medical University. The patients were treated by triceps lingual flap approach or olecranon osteotomy. The patients were treated with functional exercise after operation. The healing of fracture was analyzed and compared between the two groups. There was no malunion, nonunion, ectopic ossification and other complications. Results all 45 patients were followed up for 6-24 months with an average of 12.7 months. There was no significant difference in the operative time and healing time between the two groups. There was no bone nonunion, internal fixation failure and loosening, no elbow stiffness, and no significant difference in the incidence of postoperative complications between the two groups. The motion of elbow joint in tongue flap approach group was 77.00 卤11.93, which was lower than that in olecranon osteotomy group (96.11 卤10.32). The postoperative MEPS in the tongue flap approach group was 74.93 卤9.12, which was lower than that in the olecranon osteotomy group (83.15 卤8.52). There was no statistical difference in muscle strength of triceps brachii between the two groups. According to AO classification and stratification comparison, the curative effect of ulnar olecranon osteotomy approach on C2C3-type fracture was superior to triceps humeral triceps lingual flap approach. Conclusion: patients with ulnar olecranon osteotomy can take functional exercise early after operation, and the complications are not obviously increased, which is beneficial to the recovery of elbow joint function.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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