CAJ | 학술논문

目的：探讨垂直双钢板与平行双钢板治疗肱骨髁间粉碎性骨折的临床效果。方法选取陕西省榆林市第一医院2008年1月~2014年1月收治的肱骨髁间粉碎性骨折患者80例，按照随机数字表法分为两组，即观察组和对照组，每组40例。观察组患者采用垂直双钢板进行内固定，对照组患者采用平行双钢板进行内固定，术后随访12个月，观察并检查患者术后恢复情况，包括肘关节屈伸活动度、前臂旋转活动度及Mayo肘关节功能评分(MEPS)。结果观察组和对照组患者肘关节屈伸活动度组内不同时间点比较，差异均有统计学意义(P<0.05)。两组患者术后1、3、6、12个月的肘关节屈伸活动度比较，差异均无统计学意义(P>0.05)。观察组和对照组患者前臂旋转活动度组内不同时间点比较，差异均有统计学意义(P<0.05)。两组患者术后1、3、6、12个月的前臂旋转活动度比较，差异均无统计学意义(P>0.05)。观察组和对照组患者MEPS组内不同时间点比较，差异均有统计学意义(P<0.05)。两组患者随访3、6、10、12个月的MEPS比较，差异均无统计学意义(P>0.05)。两组患者肘关节功能恢复情况比较，差异无统计学意义(P>0.05)。两组优良率比较差异无统计学意义(P>0.05)。结论垂直双钢板和平行双钢板治疗肱骨髁间粉碎性骨折的效果无明显差异，可根据患者具体情况选择合适的内固定钢板。
목적：탐토수직쌍강판여평행쌍강판치료굉골과간분쇄성골절적림상효과。방법선취합서성유림시제일의원2008년1월~2014년1월수치적굉골과간분쇄성골절환자80례，안조수궤수자표법분위량조，즉관찰조화대조조，매조40례。관찰조환자채용수직쌍강판진행내고정，대조조환자채용평행쌍강판진행내고정，술후수방12개월，관찰병검사환자술후회복정황，포괄주관절굴신활동도、전비선전활동도급Mayo주관절공능평분(MEPS)。결과관찰조화대조조환자주관절굴신활동도조내불동시간점비교，차이균유통계학의의(P<0.05)。량조환자술후1、3、6、12개월적주관절굴신활동도비교，차이균무통계학의의(P>0.05)。관찰조화대조조환자전비선전활동도조내불동시간점비교，차이균유통계학의의(P<0.05)。량조환자술후1、3、6、12개월적전비선전활동도비교，차이균무통계학의의(P>0.05)。관찰조화대조조환자MEPS조내불동시간점비교，차이균유통계학의의(P<0.05)。량조환자수방3、6、10、12개월적MEPS비교，차이균무통계학의의(P>0.05)。량조환자주관절공능회복정황비교，차이무통계학의의(P>0.05)。량조우량솔비교차이무통계학의의(P>0.05)。결론수직쌍강판화평행쌍강판치료굉골과간분쇄성골절적효과무명현차이，가근거환자구체정황선택합괄적내고정강판。
Objective To investigate clinical effect of vertical dual plate and parallel dual plate in the treatment of humeral condylar comminuted fracture. Methods 80 patients with humeral condylar comminuted fracture treated at the First Hospital of Yulin City in Shaanxi Province from January 2008 to January 2014 were selected and divided into two groups (observation group and control group) by the random number table method. Each group of 40 cases. Observation group was treated with vertical dual plate internal fixation, control group was treated with parallel dual plate internal fixation. The patients were followed up for 12 months, the recovery of patients were observed and examined, including elbow flexion and extension activity, forearm rotation activity and Mayo elbow performance score (MEPS). Results El-bow flexion and extension activity of different time points in observation group and control group was compared respec-tively, with statistical differences (P<0.05). After operation of 1, 3, 6 and 12 months, elbow flexion and extension ac-tivity between two groups was compared respectively, with no statistical difference (P>0.05). Forearm rotation activity of different time points in observation group and control group was compared respectively, with statistical differences (P < 0.05). After operation of 1, 3, 6 and 12 months, forearm rotation activity between two groups was compared re-spectively, with no statistical difference (P > 0.05). MEPS of different time points in observation group and control group was compared respectively, with statistical differences (P< 0.05). Followed up 3, 6, 10, 12 months, MEPS be-tween two groups was compared respectively, with no statistical difference (P>0.05). Functional recovery of elbow joint between two groups was compared, with no statistical difference (P > 0.05). Excellent rate between two groups was compared, with no statistical difference (P>0.05). Conclusion There is no obvious difference on effect of vertical dual plate and parallel dual plate in the treatment of humeral condylar comminuted fracture. The appropriate internal fixa-tion plates should be chosen according to the specific circumstances of the patients.