Ilizarov骨外固定技术联合内固定治疗肘关节周围骨折

发布时间：2019-04-20 17:06

【摘要】：[目的]探讨ILizarov骨外固定技术联合内固定治疗肘关节周围骨折对临床疗效的影响。[方法]回顾性分析2009年5月~2014年12月本院收治的肘关节周围骨折患者临床资料,获得完整随访39例,纳入研究。18例采用Ilizarov骨外固定技术结合切开复位内固定手术方式,为联合固定组;男10例,女8例;平均年龄36.2岁(21~58岁)。21例采用切开复位内固定手术,为内固定组,男14例,女7例;平均年龄35.3岁(18~66岁)。术后门诊随访指导患者功能锻炼、观察骨折愈合情况,术后12个月对肘关节功能行Mayo评分,并记录肘关节屈伸活动度(ROM)。对两组患者术后肘关节功能进行对比评价。[结果]联合固定组与内固定组患者平均愈合时间分别为8.6、8.3周。Mayo评分:外固定联合组为(88.8±8.9)分,优良率88.9%;内固定组为(76.5±11.8)分,优良率为66.7%。肘关节平均活动度(ROM):联合固定组为(116.2±10.5)°;内固定组为(85.6±13.6)°。两组对比联合固定组肘关节功能明显好于内固定组(P0.05)。[结论]Ilizarov骨外固定技术联合内固定治疗肘关节周围骨折,能增加肘关节骨折内固定稳定性,并允许患者术后早期在铰链控制下进行功能锻炼,与单纯内固定相比,能有效预防关节僵硬、软组织挛缩等并发症的发生,使肘关节周围骨折术后获得满意的临床疗效。
[Abstract]:[objective] to investigate the effect of ILizarov external fixation combined with internal fixation on the treatment of elbow periarticular fractures. [methods] from May 2009 to December 2014, the clinical data of 39 patients with perielbow fracture were retrospectively analyzed and included in the study. 18 patients were treated with Ilizarov external fixation combined with open reduction and internal fixation. Combined fixation group; There were 10 males and 8 females, the mean age was 36.2 years (21 / 58 years), 21 cases were treated with open reduction and internal fixation, 14 cases were male and 7 cases were female, the mean age was 35.3 years (18 / 66 years). Postoperative outpatient follow-up guided patients with functional exercise, observed fracture healing, performed Mayo scores on elbow function 12 months after operation, and recorded elbow flexion and extension activity (ROM). The function of elbow joint after operation in two groups was compared and evaluated. [results] the average healing time of patients in the combined fixation group and the internal fixation group was 8.6 and 8.3 weeks respectively. Mayo score: (88.8 卤8.9) points in the combined external fixation group, and the excellent and good rate was 88.9%; In the internal fixation group, the score was (76.5 卤11.8) and the excellent and good rate was 66.7%. The mean mobility of elbow joint was (116.2 卤10.5) 掳in (ROM): combined fixation group and (85.6 卤13.6) 掳in internal fixation group. The elbow joint function of the combined fixation group was significantly better than that of the internal fixation group (P0.05). [conclusion] Ilizarov external fixation combined with internal fixation can increase the stability of elbow fracture internal fixation, and allow patients to exercise under hinge control early after operation, compared with simple internal fixation. It can effectively prevent the occurrence of complications such as joint stiffness, soft tissue contracture and so on, so that satisfactory clinical curative effect can be obtained after operation of elbow periarticular fracture.
【作者单位】：滨州医学院附属医院创伤骨科;
【分类号】：R687.3

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