中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2010年
4期
407-410
,共4页
肱骨骨折%骨折固定术,内%治疗结果
肱骨骨摺%骨摺固定術,內%治療結果
굉골골절%골절고정술,내%치료결과
Humeral fractures%Fracture fixation,internal%Treatment outcome
目的 探讨手术治疗肱骨小头骨折的固定方法和疗效.方法 自2004年12月至2006年12月手术治疗肱骨小头骨折16例,男8例,女8例;年龄16～65岁,平均44.9岁;按Bryan-Money分型:Ⅰ型8例,Ⅲ型1例,Ⅳ型7例.手术时间为伤后5天以内.手术经外侧入路,骨折复位后,AO拉力螺钉固定.所有患者均为新鲜闭合性骨折,无神经、血管损伤.术后根据Broberg-Money肘关节功能评分标准进行疗效评价,同时记录肘关节的屈伸活动度,前臂旋转度以及内侧稳定性.同时进行影像学评估.结果 16例手术中未发现合并有外侧副韧带损伤,均无血管、神经损伤,术后伤口一期愈合.全部病例均获得随访,随访时间24～36个月,平均29个月.骨折临床愈合时间6～11周,平均7.9周.无一例骨折畸形愈合及延迟愈合,未见肱骨小头缺血性坏死.1例有创伤性关节炎表现.术后随访肘关节屈伸活动度平均为125.8°±16.8°,前臂旋转度平均为163.1°±10.62°.术后Broberg-Money评分平均92.0分,优8例,良7例,差1例.15例患者恢复到受伤前日常的活动水平,9例患者报告可重新继续以往的健身运动.1例术后出现肘关节僵硬.结论 肱骨小头骨折的治疗需按分型计划手术;术中解剖复位和牢固固定,早期肘关节功能锻炼,近期疗效满意.
目的 探討手術治療肱骨小頭骨摺的固定方法和療效.方法 自2004年12月至2006年12月手術治療肱骨小頭骨摺16例,男8例,女8例;年齡16～65歲,平均44.9歲;按Bryan-Money分型:Ⅰ型8例,Ⅲ型1例,Ⅳ型7例.手術時間為傷後5天以內.手術經外側入路,骨摺複位後,AO拉力螺釘固定.所有患者均為新鮮閉閤性骨摺,無神經、血管損傷.術後根據Broberg-Money肘關節功能評分標準進行療效評價,同時記錄肘關節的屈伸活動度,前臂鏇轉度以及內側穩定性.同時進行影像學評估.結果 16例手術中未髮現閤併有外側副韌帶損傷,均無血管、神經損傷,術後傷口一期愈閤.全部病例均穫得隨訪,隨訪時間24～36箇月,平均29箇月.骨摺臨床愈閤時間6～11週,平均7.9週.無一例骨摺畸形愈閤及延遲愈閤,未見肱骨小頭缺血性壞死.1例有創傷性關節炎錶現.術後隨訪肘關節屈伸活動度平均為125.8°±16.8°,前臂鏇轉度平均為163.1°±10.62°.術後Broberg-Money評分平均92.0分,優8例,良7例,差1例.15例患者恢複到受傷前日常的活動水平,9例患者報告可重新繼續以往的健身運動.1例術後齣現肘關節僵硬.結論 肱骨小頭骨摺的治療需按分型計劃手術;術中解剖複位和牢固固定,早期肘關節功能鍛煉,近期療效滿意.
목적 탐토수술치료굉골소두골절적고정방법화료효.방법 자2004년12월지2006년12월수술치료굉골소두골절16례,남8례,녀8례;년령16～65세,평균44.9세;안Bryan-Money분형:Ⅰ형8례,Ⅲ형1례,Ⅳ형7례.수술시간위상후5천이내.수술경외측입로,골절복위후,AO랍력라정고정.소유환자균위신선폐합성골절,무신경、혈관손상.술후근거Broberg-Money주관절공능평분표준진행료효평개,동시기록주관절적굴신활동도,전비선전도이급내측은정성.동시진행영상학평고.결과 16례수술중미발현합병유외측부인대손상,균무혈관、신경손상,술후상구일기유합.전부병례균획득수방,수방시간24～36개월,평균29개월.골절림상유합시간6～11주,평균7.9주.무일례골절기형유합급연지유합,미견굉골소두결혈성배사.1례유창상성관절염표현.술후수방주관절굴신활동도평균위125.8°±16.8°,전비선전도평균위163.1°±10.62°.술후Broberg-Money평분평균92.0분,우8례,량7례,차1례.15례환자회복도수상전일상적활동수평,9례환자보고가중신계속이왕적건신운동.1례술후출현주관절강경.결론 굉골소두골절적치료수안분형계화수술;술중해부복위화뢰고고정,조기주관절공능단련,근기료효만의.
Objectve The purpose of the study was to evaluate the surgical treatment method and outcomes of capitellar fractures. Methods From December 2004 to December 2006, sixteen patients with a capitellar fracture were included in the study. There were eight males and eight females. According to Bryan and Morrey classification, there were eight type Ⅰ fractures, one type Ⅲ fracture and seven type Ⅳ fractures. In three of type Ⅳ, a separate trochlear fracture fragment with impaction was seen. Distal lateral column posteroinferior metaphyseal comminutiou and/or impaction was observed in association with three fractures including two type Ⅳ fractures and one type Ⅲ fracture. One Mason type Ⅰ radial head fracture occurred in association with an ipsilateral type Ⅳ capiteilum fracture. The patients ranged from sixteen to sixty-five years old, with an average age of 44.9 years. An extensile lateral exposure and articular fixation with cannu-lated compression screws were performed within five days of injury. Clinical, radiographic, and functional el-bow index rating scale of Broberg-Money were evaluated retrospectively. Results The follow-up time ranged from 24 to 36 months,with the mean of 29 months. All fractures healed at an average of 7.9 (range, 6 to 11) weeks without radiographic evidence of osteonecrosis of the fracture fragment. Average arc of motion was 125.8°±16.8° in flexion-extension and 163.1°±10.62° in pronation-supination. The mean Broberg-Mor-rey was 92.0 points, with eight excellent results, seven good results, and one poor result. There were one pa-tient with a minimum of grade 1 radio-capitellar arthrosis.Fifteen of the sixteen adults were able to continue their former professional activities. The patient had persistent postoperative stiffness with a flexion contrac-ture at the last postoperative visit. Conclusion Prompt treatment with anatomic reduction and internal fixa-tion with lag screws followed by early rehabilitation can lead to functional arc and satisfactory outcome.
