摘要
目的探究肱三头肌两侧入路治疗肱骨远端C型骨折的疗效及安全性。方法对我院2012年6月至2016年6月收治的46例肱骨远端C型骨折患者的临床资料进行回顾性分析,其中男25例,女21例,年龄45~84岁,平均63.8岁。根据手术入路不同分为尺骨鹰嘴截骨入路组(A组)和肱三头肌两侧入路组(B组)。比较两组的平均手术时间及透视次数,术后各时间点的Mayo评分、肘关节活动度及治疗的优良率。结果两组相比,B组的平均手术时间、术中透视次数明显低于A组,差异有统计学意义(P值均为0.000)。术后6周、3个月及6个月Mayo评分B组高于A组,差异有统计学意义(P值分别为0.000,0.000,0.044);术后12个月Mayo评分及优良率两组差异无统计学意义(P=0.447)。结论对于肱骨远端C型骨折,肱三头肌两侧入路保留了肱三头肌的连续性,手术时间短、减少了术中出血及透视次数,术后肱三头肌肌力无明显减弱,肘关节功能恢复良好。
Objective To investigate the efficacy and safety of triceps-sparing approach in the treatment of type C distal humerus fracture. Methods A total of 46 patients（ 25 males, 21 females） with type C distal humerus fractures were treated in our hospital from June 2012 to June 2016. The mean age was 63.8 years（ range： 45-84 years）. All patients were divided into 2 groups according to different surgical approaches： Group A（ n = 23） was applied with olecranonosteotomy approach; Group B（ n = 23） was applied with triceps-sparing approach. The operation time, intraoperative X-ray frequency, Mayo score at each time point after surgery, elbow flexion, and the excellent rate were compared between the 2 groups. Results The average operation time and intraoperative X-ray frequency of the Group B was significantly lower than that of the Group A（ P = 0.000）. The Mayo score of Group B was significantly higher than that of the Group A 6 weeks, 3 months, 6 months postoperatively（ P = 0.000, 0.000, 0.044）. No statistically significant differences were found in Mayo score and excellent and good rate between the 2 groups 12 months postoperatively（ P〉0.447）. Conclusions The triceps-sparing approach is an good approach in the treatment of type C distal humerus fractures. It preserves the continuity of triceps, shortens the operation time, reduces the intraoperative X-ray frequency. The triceps strength is no obviously weakened and elbow function recovered. It is worth of clinical promotion.
作者
吴贵佑
洪磊
李伟
朱红伟
陈国强
李文锋
WU Gui-you;HONG Lei;LI Wei;ZHU Hong-wei;CHEN Guo-qiang;LI Wen-feng(Department of Orthopaedics,the first Affiliated Hospital of PLA General Hospital,Beijing,100048,China)
出处
《中国骨与关节杂志》
CAS
2018年第7期489-493,共5页
Chinese Journal of Bone and Joint
关键词
肱骨骨折
骨折固定术
内
治疗结果
Humeral fractures
Fracture fixation
internal
Treatment outcome
