摘要
目的:探讨肱骨远端解剖型锁定接骨板(distal humeral plate,DHP)治疗老年骨质疏松性肱骨远端骨折的方法与疗效。方法:2008年9月至2010年1月,手术治疗18例老年骨质疏松性肱骨远端骨折,男3例,女15例;年龄62～83岁,平均71.4岁。骨折按照AO分型:A2型1例,A3型3例,B1型2例,B2型2例,C1型3例,C2型4例,C3型3例。经肱三头肌两侧入路或尺骨鹰嘴"V"形截骨入路,均采用切开复位DHP内固定,术后早期积极进行功能锻炼。按照Mayo肘关节功能评分(MEPS)评估疗效。结果:所有患者术后获得随访,时间11～24个月,平均14.6个月。骨折均获愈合,无感染、内固定失效或骨折再移位。肘关节平均屈伸78°(10°～131°),屈曲113°(65°～134°),伸直25°(0～75°)。MEPS评分平均(92.2±9.6)分(65～100分),其中疼痛(42.5±5.8)分(30～45分),关节活动范围(19.2±1.9)分(15～20分),稳定性(9.2±1.9)分(5～10分),日常功能(21.4±2.9)分(15～25分)。本组患者优11例,良5例,可2例。结论:应用DHP治疗老年骨质疏松性肱骨远端骨折能获得坚强固定,有利于早期肘关节功能锻炼从而获得良好治疗效果。
Objective：To study the clinical effects of AO distal humerus plate（DHP） for the treatment of distal humeral fractures in elderly osteoporotic patients.Methods：From September 2008 to January 2010,18 elderly osteoporotic patients with distal humeral fractures were treated with open reduction and internal fixation with DHP.There were 3 males and 15 females,ranging in age from 62 to 83 years（averaged,71.4 years）.According to AO classification,1 patient was Type A2,3 patients were Type A3;2 patients were Type B1,2 patients were Type B2;3 patients were Type C1,4 patients were Type C2,3 patients were Type C3.The surgical approaches were either bilateral or via olecranon process of ulna.Early mobilization was initiated after surgery.Functional results were evaluated according to the Mayo elbow performance score（MEPS）.Results：The average duration of follow-up was 14.6 months（ranged from 11 to 24 months）.All the patients had a complete healing of their fractures.There was no infection,hardware failure or loss of reduction after the operations.The average Mayo elbow performance score（MEPS） was（92.2±9.6）（65 to 100 points）,among which the score of pain was（42.5±5.8）（30 to 45 points）,the score of motion range was（19.2±1.9）（15 to 20 points）,the score of stability was（9.2±1.9）（5 to 10 points）,and the score of function was（21.4±2.9）（15 to 25 points）.According to MEPS,11 patients got excellent results,5 good and 2 fair.Conclusion：Treatment of distal humeral fractures in elderly osteoporotic patients with AO distal humeral plates can obtain immediate stabilization which facilitates early mobilization of the elbow.
出处
《中国骨伤》
CAS
2011年第8期681-683,共3页
China Journal of Orthopaedics and Traumatology
关键词
肱骨骨折
肘关节
骨折固定术
内
Humeral fractures
Elbow joint
Fracture fixation
internal
