中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
40期
6488-6494
,共7页
植入物%骨植入物%肱骨髁间骨折%Y型钢板%双钢板%手术入路
植入物%骨植入物%肱骨髁間骨摺%Y型鋼闆%雙鋼闆%手術入路
식입물%골식입물%굉골과간골절%Y형강판%쌍강판%수술입로
humeral fractures%internal fixators%elbow joint%fol ow-up studies
背景：随着AO的发展，肱骨髁间骨折行切开复位内固定治疗已经形成趋势。然而目前内固定的方法越来越多，具体使用哪种方法最合适尚无定论。<br> 目的：探讨双钢板和Y型钢板两种内固定方法及不同手术入路修复肱骨髁间骨折的临床疗效。<br> 方法：回顾性分析新疆医科大学第六附属医院骨科2003年12月至2014年5月收治的86例新鲜肱骨髁间骨折患者的临床资料，根据使用不同内固定材料将其分为两组：双钢板组44例，其中行尺骨鹰嘴截骨入路22例，肱三头肌舌行肌瓣入路22例；Y型钢板组42例，其中行尺骨鹰嘴截骨入路21例，肱三头肌舌行肌瓣入路21例。内固定后分析两组患者临床疗效及相关并发症。随访过程中采用改良Cassebaum肘关节评分系统进行治疗效果优良率的评定。<br> 结果与结论：随访12-36个月，Y型钢板组的总体优良率为76%，双钢板组的总体优良率为77%，两组对比差异无显著性意义(P >0.05)。但有趣的是，双钢板组、Y型钢板组内对比，尺骨鹰嘴截骨入路患者的优良率均高于肱三头肌舌行肌瓣入路患者，差异有显著性意义(P<0.05)。提示Y型钢板和双钢板置入内固定均是修复肱骨髁间骨折行之有效的方法，但对于不同的手术入路而言，尺骨鹰嘴截骨入路的疗效要优于肱三头肌舌行肌瓣入路。
揹景：隨著AO的髮展，肱骨髁間骨摺行切開複位內固定治療已經形成趨勢。然而目前內固定的方法越來越多，具體使用哪種方法最閤適尚無定論。<br> 目的：探討雙鋼闆和Y型鋼闆兩種內固定方法及不同手術入路脩複肱骨髁間骨摺的臨床療效。<br> 方法：迴顧性分析新疆醫科大學第六附屬醫院骨科2003年12月至2014年5月收治的86例新鮮肱骨髁間骨摺患者的臨床資料，根據使用不同內固定材料將其分為兩組：雙鋼闆組44例，其中行呎骨鷹嘴截骨入路22例，肱三頭肌舌行肌瓣入路22例；Y型鋼闆組42例，其中行呎骨鷹嘴截骨入路21例，肱三頭肌舌行肌瓣入路21例。內固定後分析兩組患者臨床療效及相關併髮癥。隨訪過程中採用改良Cassebaum肘關節評分繫統進行治療效果優良率的評定。<br> 結果與結論：隨訪12-36箇月，Y型鋼闆組的總體優良率為76%，雙鋼闆組的總體優良率為77%，兩組對比差異無顯著性意義(P >0.05)。但有趣的是，雙鋼闆組、Y型鋼闆組內對比，呎骨鷹嘴截骨入路患者的優良率均高于肱三頭肌舌行肌瓣入路患者，差異有顯著性意義(P<0.05)。提示Y型鋼闆和雙鋼闆置入內固定均是脩複肱骨髁間骨摺行之有效的方法，但對于不同的手術入路而言，呎骨鷹嘴截骨入路的療效要優于肱三頭肌舌行肌瓣入路。
배경：수착AO적발전，굉골과간골절행절개복위내고정치료이경형성추세。연이목전내고정적방법월래월다，구체사용나충방법최합괄상무정론。<br> 목적：탐토쌍강판화Y형강판량충내고정방법급불동수술입로수복굉골과간골절적림상료효。<br> 방법：회고성분석신강의과대학제륙부속의원골과2003년12월지2014년5월수치적86례신선굉골과간골절환자적림상자료，근거사용불동내고정재료장기분위량조：쌍강판조44례，기중행척골응취절골입로22례，굉삼두기설행기판입로22례；Y형강판조42례，기중행척골응취절골입로21례，굉삼두기설행기판입로21례。내고정후분석량조환자림상료효급상관병발증。수방과정중채용개량Cassebaum주관절평분계통진행치료효과우량솔적평정。<br> 결과여결론：수방12-36개월，Y형강판조적총체우량솔위76%，쌍강판조적총체우량솔위77%，량조대비차이무현저성의의(P >0.05)。단유취적시，쌍강판조、Y형강판조내대비，척골응취절골입로환자적우량솔균고우굉삼두기설행기판입로환자，차이유현저성의의(P<0.05)。제시Y형강판화쌍강판치입내고정균시수복굉골과간골절행지유효적방법，단대우불동적수술입로이언，척골응취절골입로적료효요우우굉삼두기설행기판입로。
BACKGROUND:With the development of AO, the treatment of intercondylar humeral fractures with open reduction has been a trend. However, the methods of fixation become many. There is no conclusion of which method is optimal. <br> OBJECTIVE:To investigate the clinical effect of two kinds of different fixation methods (Y-type steel plate and double steel plate) for intercondylar humeral fractures via different surgical approaches. <br> METHODA retrospective analysis of clinical data of 86 cases of fresh intercondylar humeral fractures in the Department of Orthopedics, Sixth Affiliated Hospital, Xinjiang Medical University, between December 2003 <br> and May 2014 were conducted in this study. According to the different fixation materials, patients were divided into two groupdouble steel group (n=44, including the surgical approach of ulna olecranon osteotomy which had 22 cases and the surgical approach of triceps V shaped severance which had 22 cases), Y-type steel group (n=42, including the surgical approach of ulna olecranon osteotomy which had 21 cases and the surgical approach of triceps V shaped severance which had 21 cases). The clinical curative effect and related complications of the two groups after operation were analyzed. During fol ow-up, modified Cassebaum elbow scoring system was used to evaluate the excellent and good rate of therapy. <br> RESULTS AND CONCLUSION:After fol owed up for 12-36 months, the total excellent and good rate of Y-type steel plate was 76%and the total excellent and good rate of double steel plate was 77%. There were no significant differences between the two groups (P>0.05). But interestingly, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance and the difference was statistical y significant (P<0.05). Above data suggested that Y-type steel plate and double steel plate were effective ways in the repair of intercondylar humeral fractures. However, for different surgical approaches, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance.
