摘要
目的观察尺骨鹰嘴截骨人路切开复位内固定治疗肱骨髁间粉碎性骨折的中长期疗效。方法对30例采用尺骨鹰嘴截骨人路切开复位内固定治疗的肱骨髁间粉碎性骨折患者的5年以上随访资料进行回顾性研究，男14例，女16例；年龄16,--67岁，平均38．8岁；左侧21例，右侧9例。按Riseborough—Radin分型，Ⅲ型14例，Ⅳ型16例。采用经尺骨纵轴垂直平面截骨18例，尖端在远端的多平面“V”形截骨6例，经尺骨鹰嘴关节外斜形截骨4例，2例合并尺骨鹰嘴骨折患者采用经骨折入路。采用Mayo肘关节功能评分对结果进行评价并行统计学分析。结果随访60-115个月，平均78．9个月。肘关节平均屈115．67°，伸-15．33°；Mayo评分为60-100分，平均86．83分，优14例，良12例，可4例；优良率为86．67％。尺骨鹰嘴截骨延迟愈合1例。低能量和高能量损伤患者Mayo评分平均为89．55分和79.38分；Riseborough—Radinm型和Ⅳ型患者的Mayo评分平均为90．71分和83．44分；对三种截骨方法进行Mayo评分，经尺骨纵轴垂直平面截骨平均为86．39分，尖端在远端的多平面“V”形截骨平均为91．67分，经尺骨鹰嘴关节外斜行截骨平均为90．00分。结论尺骨鹰嘴截骨入路切开复位内固定治疗肱骨髁间粉碎性骨折的中长期疗效满意，截骨方法对术后功能无明显影响。
Objective To analysis middle and long term results of humeral intercondylar fractures treated by open reduction and internal fixation via approach of olecranon osteotomy. Methods Middle and long term （over 5 years） follow-up data of 30 cases suffered from humeral intercondyler fractures treated by open reduction and internal fixation via approach of olecranon osteotomy were studied retrospectively. There were 14 males and 16 females. The mean age was 38.8 years with a range of 16 to 67 years. Twenty-one fractures involved the left elbow and 9 affected the right. According to Riseborough-Radin classification sys- tem,there were 14 cases for Ⅲ style, and 16 for 1V style. In all cases, 18 cases were treated with lateropul- sition osteotomy, 6 cases with multi-plane inverse ＂V＂ osteotomy, 4 cases with oblique osteotomy and 2 cases combined ulna olecranon fractures with fracture approach. The results were evaluated with Mayo elbow scores and analyzed statisticly method. Results These patients were followed up from 60 to 115 months with the average of 78.9 months. Average 115.67° for flexion and -15.33° for extension were obtained. The results were 60-100 with Mayo scores, average of 86.83. Fourteen cases were excellent, 12 cases were good and 4 cases were fair. The excellent and good rate was 86.67%. Delayed union of olecranon occurred in one case. There was no statistics difference for fineness of Mayo scores between Riseborough-Radin Ⅲ style and Ⅳ style, between intraarticular and extraarticular osteotomy methods. Conclusion The middle and long term results of humeral intercondyler fractures treated by open reduction and internal fixation via approach of olecranon osteotomy are satisfactory. Osteotomy methods have no influence to postoperative function.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2009年第11期1015-1018,共4页
Chinese Journal of Orthopaedics
关键词
骨折
尺骨
截骨术
肱骨
Fractures
Ulna
Osteotomy
Humerus
