目的总结经尺骨鹰嘴截骨双侧锁定加压钢板治疗C型肱骨远端骨折的疗效。 方法2008年9月－2013年5月，采用经尺骨鹰嘴截骨双侧锁定加压钢板固定治疗21例C型肱骨远端骨折患者。其中男12例，女9例；年龄18～64岁，平均38岁。致伤原因：跌伤7例，交通事故伤14例。均为新鲜闭合骨折。根据国际内固定研究协会（AO/ASIF）分型：C1型9例，C2型6例，C3型6例。受伤至手术时间5～11 d，平均7 d。 结果术后切口均Ⅰ期愈合，无感染及神经损伤发生。21例均获随访，随访时间7～24个月，平均16个月。2例于术后6个月发生异位骨化，术后1 年行异位骨化切除，功能无明显改善。患者骨折均愈合，愈合时间6～10个月，平均7.8个月。随访期间内固定物无松动、断裂及失效发生。术后6个月肘关节活动范围为60～136°，平均110°。术后6个月根据Mayo肘关节功能评分，获65～95分，平均87分；其中优16例，良1例，中4例，优良率为81%。 结论双侧锁定加压钢板治疗C型肱骨远端骨折固定牢固，利于术后早期行肘关节功能锻炼。
Citation：
王永才,王红川,楼华,闫冰,蒋俊威. 经尺骨鹰嘴截骨双侧锁定加压钢板内固定治疗C型肱骨远端骨折. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(11): 1404-1405. doi: 10.7507/1002-1892.20130305
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- 1. Robinson CM, Hill RM, Jacobs N, et al. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma, 2003, 17(1): 38-47.
- 2. Ring D, Jupiter JB. Fractures of the distal humerus. Orthop Clin North Am, 2000, 31(1): 103-113.
- 3. 陈志发, 袁慧仪, 梁加利. Fixation of distal humeral fracture in elderly patient by locking compression plate. 中国修复重建外科杂志, 2009, 23(11): 1285-1289.
- 4. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214): 160-164.
- 5. Ali AM, Hassanin EY, El-Ganainy AE, et al. Management of intercondylar fractures of the humerus using the extensor echanism-sparing paratricipital posterior approach. Acta Orthop Belg, 2008, 74(6): 747-752.
- 6. Erpelding JM, Mailander A, High R, et al. Outcomes following distal humeral fracture fixation with an extensor mechanism-on approach. J Bone Joint Surg (Am), 2012, 94(6): 548-553.
- 7. Wilkinson JM, Stanley D. Posterior surgical approaches to the elbow: a comparative anatomic study. J Shoulder Elbow Surg, 2001, 10(4): 380-382.
- 8. Ruan HJ, Liu JJ, Fan CY, et al. Incidence, management, and prognosis of early ulnar nerve dysfunction in type C fractures of distal humerus. J Trauma, 2009, 67(6): 1397-1401.
- 9. Chen RC, Harris DJ, Leduc S, et al. Is ulnar nerve transposition beneficial during open reduction internal fixation of distal humerus fractures. J Orthop Trauma, 2010, 24(7): 391-394.
