摘要
目的探讨后方入路有限切开复位肱骨远端关节外解剖锁定加压钢板（LCP）内固定治疗肱骨干中下段骨折的临床疗效。方法回顾性分析2012年12月至2016年12月期间采用有限切开复位肱骨远端关节外解剖LCP内固定治疗的22例肱骨干中下段骨折患者资料。男14例，女8例；年龄18。86岁，平均42．7岁；骨折AO／OTA分型：12_A型13例，12一B型7例，12．c型2例。收集患者手术时间、术中出血量、住院时间，末次随访时采用Mayo肘关节功能评分（MEPS）评估患侧功能。结果本组患者手术时间46～95min，平均57min；术中出血量150～400mL，平均220mL；住院时间9．13d，平均10．5d。22例患者术后获6—48个月（平均23．8个月）随访。21例患者骨折临床愈合时间为3。9个月（平均4．6个月）。1例患者发生骨不愈合，二期行骨折断端瘢痕组织清理＋植骨＋富血小板血浆植入，二期手术术后2个月x线片示骨折断端连续性骨痂丰富。末次随访时患者MEPS评分平均为88．2分，其中优16例，良4例，可2例，优良率为90．9％。结论后方入路肱骨远端关节外解剖LCP治疗肱骨干中下段骨折能获得可靠内固定，有助于早期进行康复锻炼，尤其适用于粉碎性、骨折线偏远端的肱骨干中下段骨折。
Objective To evaluate the clinical outcomes of internal fixation with extra-articular distal humerus locking compression plate （LCP） for the treatment of mid-distal humerus diaphyseal fracture. Methods From December 2012 to December 2016, a cohort of 22 patients with mid-distal humerus shaft fracture were treated by open reduction and internal fixation using extra-articular distal humerus LCP. They were 14 males and 8 females with an average age of 42.7 years （range, from 18 to 86 years） . According to AO classification, there were 13 cases of type 12-A, 7 cases of type 12-B, and 2 cases of type 12-C. The surgical time, intra-operative blood loss and hospital stay were recorded. The clinical outcomes were evaluated by the Mayo elbow performance score （MEPS） at the last follow-ups. Results Surgical time ranged from 46 to 95 minutes with an average of 57 minutes. The average blood loss was 220 mL （range, from 150 to 400 mL）. The average hospital stay was 10. 5 days （range, from 9 to 13 days）. The mean follow-up was 23.8 months （range, from 6 to 48 months）. Bone union was achieved in 21 cases after an average of 4. 6 months （range, from 3 to 9 months）, and one patient experienced bone non-union which was uneventfully healed after secondary auto platelet rich plasma （PRP） graft management. The average MEPS elbow performance score was 88.2, resulting in 16 excellent, 4 fine and 2 fair cases （excellent and fine rate： 90. 9% ） . Conclusions Since extra-articular distal humerus LCP can provide stable internal fixation, facilitating early postoperative rehabilitation, it may be considered an effective alternative osteosynthesis for mid-distal comminuted humeral diaphyseal fractures.
出处
《中华创伤骨科杂志》
CSCD
北大核心
2017年第10期907-910,共4页
Chinese Journal of Orthopaedic Trauma
关键词
肘关节
肱骨骨折
骨折固定术
内
治疗结果
Elbow joint
Humeral fractures
Fracture fixation, internal
Treatment outcome
