摘要
[目的]探讨应用后正中入路Y形钢板内固定治疗复杂肱骨干下2/3骨折的治疗方法和临床效果。[方法]2001年11月～2006年2月采用后正中入路Y形钢板内固定治疗33例复杂肱骨干下2/3骨折患者,其中男28例,女5例,年龄19～57岁,平均37.6岁。按照AO/ASIF分型标准:C1型21例,C2型3例,C3型9例。其中7例为开放性骨折(GustiloⅠ型4例,Ⅱ型3例)。有21例采用自体髂骨植骨和12例采用同种异体骨植骨。受伤至手术时间为2.5 h～7 d,平均3 d。[结果]33例患者全部获得随访6～28个月,平均15.6个月。31例于术后19周内骨折骨性愈合。骨折延迟愈合2例。肘关节功能按Morrey评定标准进行评定,优24例,良7例,差2例。术后伸肘肌力为4～5级。[结论]后正中入路Y形钢板内固定治疗复杂肱骨干下2/3骨折安全有效。保护桡神经和尺神经、预防性植骨及术后合理功能锻炼是取得满意临床效果的重要因素。
[ Objective]To investigate the treatment method and clinical outcome of posterior midline approach and internal fixation with Y-shaped plate for complex distal 2/3 humeral fracture. [ Method] From November 2001 to February 2006,33 patients with complex distal 2/3 humeral fracture were treated with posterior midline approach and Y- shaped plate internal fixation. There were 5 females and 28 males, with a mean age of 37.6 years（ ranging from 19 to 57 years）. According to AO/ASIF classification, type C1 fracture was found in 21 cases, type C2 in 3 cases and type C3 in 9 cases. Seven of these were open fractures （4 cases of Gustilo-Anderson type I and 3 cases of type I1 ）. Measures of auto-ilium transplant （21 cases）arid homolegous allograft bone transplant （12 cases）were also taken. The operation was performed at 2.5 hours -7 days after injury with mean 3 days. [ Result] Thirty-three patients were followed up for a mean period of 15.6 months （6 -28 months）. Fractures of 31 patients healed at 19 weeks after the treatment. Delayed union occurred in two patients. The function of the elbow was evaluated according to Morreyg scale, the results showed excellent in 24 cases, good in 7 cases, and poor in 2 cases. At the last follow-up, the muscle strength of elbow extension was about 4 -5 grade. [ Conclusion] Posterior midline approach and Y-shaped plate intemal fixation of complex distal 2/3 of humeral fracture is a safe and effective technique. Protecting the radial nerve and ulnar nerve, prophylactic bone grafting and reasonable postoperative rehabilitation are very important to obtain satisfactory clinical outcome.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第14期1052-1054,共3页
Orthopedic Journal of China
关键词
肱骨骨折
骨折内固定术
手术人路
治疗结果
humeral fracture
fracture internal fixation
operative approach
treatment outcome
