CAJ | 학술논문

目的比较三种内固定技术治疗肱骨远端C型骨折的临床疗效.方法选择2003年1月-2010年10月采用双张力带固定、双钢板垂直固定和双钢板平行固定治疗的75例肱骨远端C型骨折患者,其中张力带固定(A组)22例,AO分型:C1型5例,C2型11例,C3型6例;双钢板垂直固定(B组)27例,AO分型:C1型4例,C2型13例,C3型10例;双钢板平行固定(C组)26例,AO分型:C1型7例,C2型10例,C3型9例.所有患者均取肘后正中切口,采用肱三头肌两侧或尺骨鹰嘴截骨入路.分别就内固定方式、肘关节伸屈活动度及并发症等指标进行分析,根据改良的Cassebaum评分系统进行功能评定.结果所有患者均获得平均18个月随访.骨折均获得骨性愈合,无一例发生伤口感染.最终随访时,肘关节伸屈活动度:A组为(122.06±13.13)°,B组为(118.70±12.37)°,C组为(119.90±11.79)°,三组之间差异无统计学意义(P＞0.05).优良率:A组为82％,B组为85％,C组为85％ (P ＞0.05).结论三种内固定技术治疗肱骨远端C型骨折均可获得较好的临床效果,符合肱骨远端生物力学要求.
목적 비교삼충내고정기술치료굉골원단C형골절적림상료효.방법 선택2003년1월-2010년10월채용쌍장력대고정、쌍강판수직고정화쌍강판평행고정치료적75례굉골원단C형골절환자,기중장력대고정(A조)22례,AO분형:C1형5례,C2형11례,C3형6례;쌍강판수직고정(B조)27례,AO분형:C1형4례,C2형13례,C3형10례;쌍강판평행고정(C조)26례,AO분형:C1형7례,C2형10례,C3형9례.소유환자균취주후정중절구,채용굉삼두기량측혹척골응취절골입로.분별취내고정방식、주관절신굴활동도급병발증등지표진행분석,근거개량적Cassebaum평분계통진행공능평정.결과 소유환자균획득평균18개월수방.골절균획득골성유합,무일례발생상구감염.최종수방시,주관절신굴활동도:A조위(122.06±13.13)°,B조위(118.70±12.37)°,C조위(119.90±11.79)°,삼조지간차이무통계학의의(P＞0.05).우량솔:A조위82％,B조위85％,C조위85％ (P ＞0.05).결론 삼충내고정기술치료굉골원단C형골절균가획득교호적림상효과,부합굉골원단생물역학요구.
Objective To compare effects of three internal fixation techniques in treatment of type C distal humeral fractures.Methods The study involved 75 patients with type C distal humeral fractures undergone double tension band fixation (Group A,n =22),vertical dual-plate fixation (Group B,n =27),or parallel dual-plate fixation (Group C,n =26) between January 2003 and October 2010.According to AO classification of fractures,there were five patients with type C1,11 with type C2 and six with type C3 in Group A; four with type C1,13 with type C2 and 10 with type C3 in Group B; seven with type C1,10 with type C2 and nine with type C3 in Group C.Bilateral approach through triceps brachii or olecranon osteotomy following median incision over posterior elbow was undertaken for all the patients.An analysis was made on indices like fixation modes,elbow range of extension and flexion,and complications.In addition,elbow function was assessed according to the modified Cassebaum scoring system.Results All patients were followed up for average 18 months,which showed bone union without wound infection.At the last follow-up,extension and flexion of the elbow was (122.06 ± 13.13)° in Group A,(118.70 ± 12.37)° in Group B,and (119.90 ± 11.79)° in Group C respectively,with no significant differences among groups(P ＞ 0.05).Overall excellence rate was 82％ in Group A,85％ in Group B and 85％ in Group C,respectively (P ＞ 0.05).Conclusion All three internal fixation techniques can attain a good clinical outcome in treatment of type C distal humeral fracture and satisfy the biomechanical requests of distal humerus.