CAJ | 학술논문

目的探讨经肱三头肌内外侧联合人路(triceps-sparing approach,TSA)双钢板内固定治疗C1、C2型(AO/ASIF)肱骨髁间骨折的疗效.方法对7例肱骨髁间粉碎性骨折(C1型3例,C2型4例)的患者,采用经肱三头肌内外侧联合入路,双钢板及髁间空心钉固定.结果术后随访时间为8～18个月,平均15个月.根据Mayo评分系统(MEPS)评定:优5例,良2例.肘关节平均屈曲角度为(118.6±11.4)°,平均伸直角度丢失(22.9±12.1)°,肘关节携带角(20±5)°.无一例出现内固定松动、断裂.结论经肱三头肌内外侧联合入路治疗C4、C2型肱骨髁间骨折是较理想的手术入路,具有暴露充分、骨折达到良好复位固定及术后早期康复等优点.
목적 탐토경굉삼두기내외측연합인로(triceps-sparing approach,TSA)쌍강판내고정치료C1、C2형(AO/ASIF)굉골과간골절적료효.방법 대7례굉골과간분쇄성골절(C1형3례,C2형4례)적환자,채용경굉삼두기내외측연합입로,쌍강판급과간공심정고정.결과 술후수방시간위8～18개월,평균15개월.근거Mayo평분계통(MEPS)평정:우5례,량2례.주관절평균굴곡각도위(118.6±11.4)°,평균신직각도주실(22.9±12.1)°,주관절휴대각(20±5)°.무일례출현내고정송동、단렬.결론 경굉삼두기내외측연합입로치료C4、C2형굉골과간골절시교이상적수술입로,구유폭로충분、골절체도량호복위고정급술후조기강복등우점.
Objective To evaluate the treatmene results of double plating of type C1,C2(AO/ASIF) intercondylar fractures of the distal humerus through combinod mediolateral tricepe-sparing approach (TSA).Methods A retrospective analysis of 7 cases of intercondylar comminuted fractures of the distal humerus was conducted. There were 3 cases of type C1 and 4 cases of type C2. All the patients were treated with open reduction and double plate and cannulated screw fixation through combined mediolateral triceps-sparing approach. Results Postoperative follow up period was 15 montks (range, 8 to 18 months). Results were evaluated using the Mayo Elbow Performance Score (MEPS). Five cases were graded as excellent, while 2 cases good. Average elbow flexion was (118.6±11.4)°. Average extension lag was (22.9±12.1)°. Carrying angle was (20±5)°. No implant loosening or breakage was noted. Conclusion Combined mediolateral TSA is an ideal approach for fixation of type C1, C2 intercondylar fractures of the distal humerus in that it provides adequate exposure to the fracture site, facilitates fracture reduction and allows early rehabilitation.