CAJ | 학술논문

目的：探讨不同术式对肱骨远端C型骨折治疗的临床疗效。方法将2012年8月～2013年7月行手术治疗的肱骨远端C型骨折患者49例[男性30例，女性19例；年龄22～67岁，平均（37±3.4）岁]分为4组（ A组：肱三头肌劈开入路＋双锁定钢板垂直放置15例； B组：肱三头肌劈开入路＋双锁定钢板平行放置12例； C组：鹰嘴截骨入路＋双锁定钢板垂直放置13例； D组：鹰嘴截骨入路＋双锁定钢板平行放置9例）。术后随访10～21个月，根据肘关节改良Cassebaum评分对骨折愈合时间及肘关节功能进行对比分析。结果4组病例骨折愈合平均时间分别为92、96、102、95d，功能优良率分别为80.0％、83.3％、76.9％、77.8％；4组对比均无统计学意义（P＞0.05），C组出现1例骨延迟愈合，D组出现1例异位骨化。结论不同术式治疗肱骨远端C型骨折的疗效无明显差异，建议根据骨折类型及术者经验选择熟悉的入路及内固定方式。
목적：탐토불동술식대굉골원단C형골절치료적림상료효。방법장2012년8월～2013년7월행수술치료적굉골원단C형골절환자49례[남성30례，녀성19례；년령22～67세，평균（37±3.4）세]분위4조（ A조：굉삼두기벽개입로＋쌍쇄정강판수직방치15례； B조：굉삼두기벽개입로＋쌍쇄정강판평행방치12례； C조：응취절골입로＋쌍쇄정강판수직방치13례； D조：응취절골입로＋쌍쇄정강판평행방치9례）。술후수방10～21개월，근거주관절개량Cassebaum평분대골절유합시간급주관절공능진행대비분석。결과4조병례골절유합평균시간분별위92、96、102、95d，공능우량솔분별위80.0％、83.3％、76.9％、77.8％；4조대비균무통계학의의（P＞0.05），C조출현1례골연지유합，D조출현1례이위골화。결론불동술식치료굉골원단C형골절적료효무명현차이，건의근거골절류형급술자경험선택숙실적입로급내고정방식。
Objective To explore the clinical efficacy of different surgical methods for the treatment of dis-tal humerus fractures of adults.Methods From Aug.2012 to Jul.2013,49 patients[30 males and 19 females aged from 22-67 years with an awerage of (37 ±3.4) years] of distal humerus fracture were treated with perpendicular plate fixation via a triceps-splitting approach(group A,15 cases),parallel plate fixation via a triceps-splitting ap-proach(group B, 12 cases),perpendicular plate fixation via an olecranon osteotomy approach(group C,13 cases), parallel plate fixation via an olecranon osteotomy approach( group D,9 cases) respectively.All patients received 10-21 months of follow-up and Cassebaum functional score was employed to evaluate the treatment results.Results In four groups,the average healing time of fracture were 92,96,98 and 95 days, respectively.The excellent and good rates of function were 80.0%,83.3%,76.9% and 77.8%, respectively.All the data were analyzed with statis-tics.There was no significant difference among groups(P>0.05).Delayed union occurred in one case in group C,and 1 case developed heterotopic ossification in group D.Conclusion As four methods have their own advanta-ges,the clinical choice should be based on the fracture type and the proficiency of the surgical operator.