双钢板治疗成年人肱骨髁上粉碎骨折疗效分析

发布时间：2018-06-09 16:34

本文选题：肱骨远端 + 骨折　；参考：《医学与哲学(B)》2017年04期

【摘要】：探讨成年人使用双钢板内固定治疗肱骨髁上粉碎骨折的方法及疗效。回顾笔者所在医院2013年1月~2015年1月成年人肱骨髁上粉碎性骨折使用双钢板治疗32例,骨折按AO/ASIF分型法分型,均为C型,其中C1型10例,C2型17例,C3型5例。均采用肘后正中切口,行双钢板螺钉内固定治疗。其中尺骨鹰嘴截骨19例,经翻肱三头肌舌形瓣13例。手术顺序:先关节内骨折关节面复位,克氏针临时固定,使复杂骨折变为简单的肱骨髁上骨折,然后再行干骺端复位。内固定方式,选用肱骨远端内外侧解剖钢板相互垂直固定肱骨髁内外两柱。本组平均随访18个月,骨折愈合时间8周~16周,28例术后功能良好,2例关节间隙狭窄,2例骨化性肌炎,无尺神经损伤及骨不愈合发生,优良率87.5%。成年人C型肱骨髁上骨折,结构复杂,相互垂直双钢板内固定治疗,固定强度及效果都优于其他固定方式,利于肘关节的功能恢复及早期功能锻炼,是一种理想的治疗方法。
[Abstract]:To explore the treatment of supracondylar comminuted humerus fracture with double plate fixation in adults. From January 2013 to January 2015, 32 adult supracondylar comminuted fractures of humerus were treated with double plate. According to AOP / Asif classification, all fractures were classified as C type, including 10 cases of C1 type C _ 2 type and 17 cases of C _ 3 type. All patients were treated with double plate and screw internal fixation through posterior median cubitus incision. There were 19 cases of olecranon osteotomy and 13 cases of lingual flap of transposition triceps muscle. Operation sequence: first reduction of articular surface of intra articular fracture and temporary fixation with Kirschner needle, making complex fracture into simple supracondylar fracture of humerus, then metaphyseal reduction. In internal fixation, the distal humerus internal and external anatomical plates were used to fix the humeral condylar and lateral humeral condylar columns vertically. The average follow-up was 18 months. The healing time of fracture was 8 weeks and 16 weeks after operation in 28 cases with good function and 2 cases with ossification myositis without ulnar nerve injury and bone nonunion. The excellent and good rate was 87.5%. Adult C-type supracondylar humerus fracture with complex structure, vertical double plate internal fixation, fixation strength and effect are superior to other fixation methods, which is beneficial to the functional recovery and early functional exercise of elbow joint, and is an ideal treatment method.
【作者单位】：大连市第三人民医院骨科;
【分类号】：R687.3

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