摘要
目的：比较改良外侧入路与前外侧入路切开复位钢板内固定治疗肱骨干中远段骨折的疗效。方法回顾性对2011年1月—2013年7月采用改良外侧入路与前外侧入路切开复位钢板内固定治疗35例肱骨干中远段骨折患者的临床资料进行分析，并从手术时间、手术出血量、术中桡神经损伤情况、临床骨折愈合时间、术后1年肘关节伸屈活动范围及Mayo肘关节功能评分（MEPS）等方面对两种入路进行疗效比较。结果所有患者均获得12～21个月的随访，平均随访时间14．2个月，前外侧入路组平均手术时间（133．15±10．01）min，平均术中出血量（313．68±22．41）mL，术中发生3例桡神经损伤（3／19），术后骨折平均愈合时间（14．00±1．21）周，术后1年肘关节平均活动范围：屈曲（129．74±8．11）°，伸直（4．21±1．23）°，术后1年肘关节MEPS功能平均评分（84．37±6．53），改良外侧入路组平均手术时间（107．81±9．12）min，平均术中出血量（263．75±17．46）mL，术中发生1例桡神经损伤（1／16），术后骨折平均愈合时间（13．84±1．07）周，术后1年肘关节平均活动范围：屈曲（133．75±6．31）°;，伸直（4．63±1．09）°，术后1年肘关节MEPS功能平均评分（86．44±8．02），改良外侧入路组在手术时间、术中出血量及桡神经损伤方面优于前外侧入路组（P＜0．05），而改良外侧入路组在术后骨折愈合时间、术后1年肘关节伸屈活动范围与肘关节MEPS功能评分方面与前外侧组之间无明显统计学差异（P＞0．05）。结论改良外侧入路相对前外侧入路手术治疗肱骨中远段骨折更加简单而安全，是一种比较好的手术入路。
Objective To compare treatment results and complication rates between anterolateral and modified lateral approach in man-agement of mid-distal humeral shaft fractures.Methods Between January 2011 and July 2013,a total of 35 patients with mid-distal humeral shaft fractures were treated by anterolateral or modified lateral approaches.Of the patients,19 were operated by the anterolateral approach （group I）and 16 patients were operated by the modified lateral approach （group II）.There was no statistical significance be-tween the two groups in sex distribution,age,injured arms,radial nerve injury,AO/ASIF classification,and the time from injury to sur-gery （P〉0.05）.Operation time,intraoperative bleeding volume,clinical outcomes,iatrogenic radial nerve injury during operation and complications were compared between the two groups.The elbow functional results were evaluated by the Mayo Elbow Performance Score （MEPS）at 1 year after the operation.Results All patients were followed up for 12-21 months;The average of follow-up was 14.2 months.There were significant differences in the operation time [（133.15 ±10.01）min vs （107.81 ±9.12）min],intraoperative bleeding volumes [（313.68 ±22.41）mL vs （263.75 ±17.46）mL]and iatrogenic radial nerve injury （3 cases vs 1 case）during the operation between the two groups （P〉0.05）.There were no significant differences in the mean time of bone union[（14.00 ±1.21） weeks vs（13.84 ±1.07）weeks],range of elbow flexion[（129.74 ±8.11）°vs （133.75 ±6.31）°,range of elbow extension[（4.21 ± 1.23）°vs （4.63 ±1.09）°and MEPS at 1 year after the operation[（84.37 ±6.53 ）vs（86.44 ±8.02）]between the two groups （P〉0.05）.Conclusions The modified lateral approaches acquired satisfied treatment results in the management of mid-distal humeral shaft fractures,compared with anterolateral approach,which is a safe and easy surgical approach.
出处
《安徽医药》
CAS
2015年第6期1119-1122,共4页
Anhui Medical and Pharmaceutical Journal
关键词
肱骨中远段骨折
前外侧入路
改良外侧入路
桡神经损伤
疗效
mid-distal humeral shaft fractures
anterolateral approach
modified lateral approach
radial nerve injury
curative effect
