摘要
目的探讨尺骨鹰嘴截骨入路和肱三头肌舌状瓣入路治疗肱骨远端C型骨折的临床疗效。方法回顾性分析2016年10月至2019年5月收治的肱骨远端C型骨折患者52例的病历资料,按照手术入路方式的不同,分成A组(尺骨鹰嘴截骨入路)27例及B组(肱三头肌舌状瓣入路)25例,对两组手术时间、术中出血量、术后第2天血清肌酸激酶(CK)浓度、骨折愈合时间、肘关节功能评分及术后并发症方面进行比较。结果52例患者随访时间10~19(15.72±3.61)个月。B组在手术时间、术中出血量方面明显低于A组,差异具有统计学意义(P<0.05);A组术后第2天血清CK浓度明显低于B组,差异具有统计学意义(P<0.05);两组在骨折愈合时间、肘关节功能评分、并发症方面差异无统计学意义(P>0.05)。结论两种手术入路在治疗肱骨远端C型骨折方面,均可重建肘关节功能,达到有效治疗骨折的目的。肱三头肌舌状瓣入路可有效缩短手术时间,减少术中出血,但对肌肉的损伤较尺骨鹰嘴截骨入路大。
Objective To investigate the clinical efficacy of the ulnar olecranon osteotomy approach and the hyoid flap of triceps brachii approach in the treatment of type C fracture of distal humerus.Methods Fifty-two patients with type C fracture of distal humerus from October 2016 to May 2019 were analyzed retrospectively.According to the different operative approaches,they were divided into group A(the ulnar olecranon osteotomy approach,n=27)and group B(the hyoid flap of triceps brachii approach,n=25).The operation time intraoperative bleeding volume,serum creatine kinase(CK)concentration 2 days after operation,fracture healing time,elbow joint function score,and complications were compared between the two groups.Results The 52 patients were followed up for 10 to 19(15.72±3.61)months.The operation time and intraoperative bleeding volume of group B were significantly lower than those of group A,and the differences were statistically significant(P<0.05).The serum creatine kinase(CK)concentration on two days post-operation in group A was significantly lower than that in group B 2 days after operation,and the difference was statistically significant(P<0.05).There was no significant difference in fracture healing time,elbow joint function score,and complications between the 2 groups(P>0.05).Conclusion Both surgical approaches can reconstruct the function of the elbow joint and achieve effective treatment of fractures in the treatment of type C fracture of distal humerus.The hyoid flap of triceps brachii approach can effectively shorten the operation time and reduce intraoperative bleeding,but the damage to the muscle is greater than that through the ulnar olecranon osteotomy approach.
作者
祁雷
吴延滨
谈志俊
张明军
张濒
李子煜
余水生
QI Lei;WU Yanbin;TAN Zhijun;ZHANG Mingjun;ZHANG Bin;LI Ziyu;YU Shuisheng(Department of Orthopedics,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China;Department of Orthopedics,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)
出处
《邵阳学院学报（自然科学版）》
2020年第5期75-80,共6页
Journal of Shaoyang University：Natural Science Edition
关键词
肱骨远端骨折
手术入路
并发症
疗效
distal humeral fracture
surgical approach
complications
curative efficacy
