CAJ | 학술논문

目的探讨经尺骨鹰嘴截骨入路双钢板固定治疗肱骨远端C型骨折的疗效.方法选择2008年7月-2010年4月经尺骨鹰嘴截骨入路、双钢板治疗肱骨远端C型骨折患者19例,其中男11例,女8例;年龄27 ～71岁,平均49.2岁.致伤原因:交通伤10例,摔伤7例,高处坠落伤2例.骨折按AO/美国骨创伤协会(OTA)分型标准:C2型9例,C3型10例.合并尺神经损伤2例,桡神经损伤1例.结果术后切口均Ⅰ期愈合.19例均获随访,时间12～ 20个月,平均15.9个月.X线片示骨折与鹰嘴截骨于术后8～18周愈合,平均12周.随访期间无内固定失败、骨化性肌炎、畸形愈合及延迟愈合、不愈合发生.末次随访时Mayo肘关节评分(Mayo elbow performance score,MEPS)为75 ～ 100分,平均94.8分;优14例,良3例,一般2例,优良率为90％.结论经尺骨鹰嘴截骨入路双钢板固定治疗肱骨远端粉碎骨折,具有内固定坚强、可以早期功能锻炼等优点,术后疗效满意.
목적 탐토경척골응취절골입로쌍강판고정치료굉골원단C형골절적료효.방법 선택2008년7월-2010년4월경척골응취절골입로、쌍강판치료굉골원단C형골절환자19례,기중남11례,녀8례;년령27 ～71세,평균49.2세.치상원인:교통상10례,솔상7례,고처추락상2례.골절안AO/미국골창상협회(OTA)분형표준:C2형9례,C3형10례.합병척신경손상2례,뇨신경손상1례.결과 술후절구균Ⅰ기유합.19례균획수방,시간12～ 20개월,평균15.9개월.X선편시골절여응취절골우술후8～18주유합,평균12주.수방기간무내고정실패、골화성기염、기형유합급연지유합、불유합발생.말차수방시Mayo주관절평분(Mayo elbow performance score,MEPS)위75 ～ 100분,평균94.8분;우14례,량3례,일반2례,우량솔위90％.결론 경척골응취절골입로쌍강판고정치료굉골원단분쇄골절,구유내고정견강、가이조기공능단련등우점,술후료효만의.
Objective To evaluate effect of construction with dual plates via olecranon osteotomy approach in treatment of type C distal humeral fractures.Methods The study involved 19 patients with type C distal humeral fractures treated by olecranon osteotomy and double plate fixation between July 2008 and April 2010,including 11 males and 8 females at a mean age of 49.2 years (range,27-71 years).Fractures were causes by traffic accidents in 10 patients,tumble in seven and fall from height in two.According to Association for Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification,there were nine patients with type C2 and 10 with type C3 fractures.Besides,two patients were complicated by ulnar nerve injuries and one by radial nerve injury.Results Primary wound healing was achieved in all patients after operation.All patients were followed up for average 15.9 months (range,12-20 months).X-ray films revealed that both fracture and olecranon osteotomy sites were healed in average 12 weeks (range,8-18 weeks).No fixation failure,myositis ossificans,malunion,delayed union or disunion occurred during the follow-up.Average Mayo elbow performance score (MEPS) was 94.8 points (range,75-100 points) at the last follow-up,which showed excellent results in 14 patients,good in three,and fair in two,with excellence rate of 90％.Conclusions Double plate fixation via olecranon osteotomy gains advantages of solid fixation and early functional exercise in treatment of comminuted intercondylar fractures of humerus.Moreover,postoperative outcome is satisfactory.