CAJ | 학술논문

目的介绍内外侧新型解剖型接骨板治疗肱骨髁间骨折的手术方法和疗效.方法自2007年3月至2009年9月手术治疗肱骨髁间骨折35例,男27例,女8例;年龄21～87岁,平均46.2岁;左侧21例,右侧14例.骨折按照AO分型:C1型19例,C2型11例,C3型5例.经肱三头肌两侧入路或尺骨鹰嘴"V"形截骨2路,采用肱骨远端解剖接骨板治疗25例,采用肱骨远端解剖锁定接骨板治疗10例,术后早期积极进行功能锻炼.结果所有患者术后获得6～24个月(平均14个月)随访,均获骨性愈合,术后未发生感染、内固定松动、异位骨化等并发症.肘关节平均屈伸81°(9～131°),屈曲110°(66～135°),伸直22°(0～75°).Mayo肘关节功能评分平均92分(62～100分),其中优20例,良10例,可4例,差1例,优良率为85.7%.疗效差的1例为C3型骨折合并颅脑外伤,术后未能及早行功能锻炼,造成肘关节僵硬.结论采用内外侧新型解剖型接骨板治疗肱骨髁间骨折能获得坚强固定,有利于早期肘关节功能锻炼从而获得优良治疗效果.
목적 개소내외측신형해부형접골판치료굉골과간골절적수술방법화료효.방법 자2007년3월지2009년9월수술치료굉골과간골절35례,남27례,녀8례;년령21～87세,평균46.2세;좌측21례,우측14례.골절안조AO분형:C1형19례,C2형11례,C3형5례.경굉삼두기량측입로혹척골응취"V"형절골2로,채용굉골원단해부접골판치료25례,채용굉골원단해부쇄정접골판치료10례,술후조기적겁진행공능단련.결과 소유환자술후획득6～24개월(평균14개월)수방,균획골성유합,술후미발생감염、내고정송동、이위골화등병발증.주관절평균굴신81°(9～131°),굴곡110°(66～135°),신직22°(0～75°).Mayo주관절공능평분평균92분(62～100분),기중우20례,량10례,가4례,차1례,우량솔위85.7%.료효차적1례위C3형골절합병로뇌외상,술후미능급조행공능단련,조성주관절강경.결론 채용내외측신형해부형접골판치료굉골과간골절능획득견강고정,유리우조기주관절공능단련종이획득우량치료효과.
Objective To introduce a new type of bilateral anatomical plates used for treatment of intercondylar fractures of humerus. Methods From March 2007 to September 2009, we treated 35 patients with intercondylar fracture of humerus with distal anatomical humeral plates(Zimmer) and distal anatomical humeral locking plates (Synthes). By AO classification, there were 19 elbows of C1, 11 elbows of C2 and 5 elbows of C3. The surgical approach was either bilateral or via olecranon process of ulna. Early mobilization was initiated after surgery. Results All the patients were followed up with a mean follow-up period of 14 months. No non-union was discovered. According to Mayo elbow performance score (MEPS), 20cases were excellent, 10 were good, 4 were fair and one was poor. Conclusion Treatment of an intercondylar humeral fracture with bilateral anatomical plates can gain immediate stabilization which facilitates early mobilization of the elbow.