摘要
背景:随着AO的发展,肱骨髁间骨折行切开复位内固定治疗已经形成趋势。然而目前内固定的方法越来越多,具体使用哪种方法最合适尚无定论。目的:探讨双钢板和Y型钢板两种内固定方法及不同手术入路修复肱骨髁间骨折的临床疗效。方法:回顾性分析新疆医科大学第六附属医院骨科2003年12月至2014年5月收治的86例新鲜肱骨髁间骨折患者的临床资料,根据使用不同内固定材料将其分为两组:双钢板组44例,其中行尺骨鹰嘴截骨入路22例,肱三头肌舌行肌瓣入路22例;Y型钢板组42例,其中行尺骨鹰嘴截骨入路21例,肱三头肌舌行肌瓣入路21例。内固定后分析两组患者临床疗效及相关并发症。随访过程中采用改良Cassebaum肘关节评分系统进行治疗效果优良率的评定。结果与结论:随访12-36个月,Y型钢板组的总体优良率为76%,双钢板组的总体优良率为77%,两组对比差异无显著性意义(P>0.05)。但有趣的是,双钢板组、Y型钢板组内对比,尺骨鹰嘴截骨入路患者的优良率均高于肱三头肌舌行肌瓣入路患者,差异有显著性意义(P<0.05)。提示Y型钢板和双钢板置入内固定均是修复肱骨髁间骨折行之有效的方法,但对于不同的手术入路而言,尺骨鹰嘴截骨入路的疗效要优于肱三头肌舌行肌瓣入路。
BACKGROUND：With the development of AO, the treatment of intercondylar humeral fractures with open reduction has been a trend. However, the methods of fixation become many. There is no conclusion of which method is optimal. 〈br〉 OBJECTIVE：To investigate the clinical effect of two kinds of different fixation methods （Y-type steel plate and double steel plate） for intercondylar humeral fractures via different surgical approaches. 〈br〉 METHODA retrospective analysis of clinical data of 86 cases of fresh intercondylar humeral fractures in the Department of Orthopedics, Sixth Affiliated Hospital, Xinjiang Medical University, between December 2003 〈br〉 and May 2014 were conducted in this study. According to the different fixation materials, patients were divided into two groupdouble steel group （n=44, including the surgical approach of ulna olecranon osteotomy which had 22 cases and the surgical approach of triceps V shaped severance which had 22 cases）, Y-type steel group （n=42, including the surgical approach of ulna olecranon osteotomy which had 21 cases and the surgical approach of triceps V shaped severance which had 21 cases）. The clinical curative effect and related complications of the two groups after operation were analyzed. During fol ow-up, modified Cassebaum elbow scoring system was used to evaluate the excellent and good rate of therapy. 〈br〉 RESULTS AND CONCLUSION：After fol owed up for 12-36 months, the total excellent and good rate of Y-type steel plate was 76%and the total excellent and good rate of double steel plate was 77%. There were no significant differences between the two groups （P〉0.05）. But interestingly, the surgical approach of ulna;olecranon osteotomy was better than the surgical approach of triceps V shaped severance and the difference was statistical y significant （P〈0.05）. Above data suggested that Y-type steel plate and double steel plate were effective ways in the repair of intercondylar humeral fractures. However, for different surgical approaches, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance.
出处
《中国组织工程研究》
CAS
CSCD
2014年第40期6488-6494,共7页
Chinese Journal of Tissue Engineering Research
