不同肘后入路双垂直钢板置入内固定治疗肱骨远端C型骨折的效果

沈家志

【摘要】 目的：對比研究不同肘后入路双垂直钢板置入内固定治疗肱骨远端C型骨折的效果。方法：抽取2017年1月-2018年8月笔者所在医院收治的60例肱骨远端C型骨折患者作为研究对象，分析两组基本资料，根据不同肘后入路方式将60例患者分为对照组、试验组，每组30例。对照组行尺骨鹰嘴截骨入路双垂直钢板置入内固定治疗，试验组行肱三头肌舌肌瓣入路双垂直钢板置入内固定治疗。对比两组临床观察指标、肘关节功能评分、关节活动度、并发症发生率。结果：试验组手术出血量少于对照组，手术时间、骨折愈合时间、复健时间均短于对照组（P<0.05）;试验组肘关节功能评分、关节活动度均优于对照组（P<0.05）;试验组并发症发生率低于对照组（P<0.05）。结论：不同肘后入路双垂直钢板置入内固定治疗肱骨远端C型骨折均有一定的临床效果，但采用肱三头肌舌肌瓣入路双垂直钢板置入内固定治疗，预后效果好，对改善患者肘关节功能与活动度具有重要作用，同时还可减少并发症发生率，临床应用价值较高，值得推广。

【关键词】 尺骨鹰嘴截骨入路; 肱三头肌舌肌瓣入路; 双垂直钢板置入内固定; 肱骨远端C型骨折; 临床疗效

doi：10.14033/j.cnki.cfmr.2019.27.068 文献标识码 B 文章编号 1674-6805（2019）27-0-03

Effect of Internal Fixation with Double Vertical Plates Through Different Posterior Elbow Approaches in the Treatment of Distal Humeral Type C Fractures/SHEN Jiazhi.//Chinese and Foreign Medical Research，2019，17（27）：-160

【Abstract】 Objective：To compare and study the effect of internal fixation with double vertical plates through different posterior elbow approaches in the treatment of distal humeral type C fracture.Method：From January 2017 to August 2018，a total of 60 patients with distal humeral type C fracture admitted to our hospital were selected as research objects.The basic data of two groups were analyzed.According to different ways of posterior elbow approach，60 patients were divided into the control group and the experimental group，30 cases in each group.The control group was treated with internal fixation with double vertical plate through olecranon osteotomy approach，while the experimental group was treated with internal fixation with double vertical plate through triceps muscularis flap approach.The clinical observation indexes，elbow function score，range of joint motion and incidence of complications were compared between the two groups.Result：The bleeding volume of the experimental group was less than that of the control group，and operation time，fracture healing time and rehabilitation time of the experimental group were shorter than those of the control group（P<0.05）.The elbow function score and range of joint motion of the experimental group were better than those of the control group（P<0.05）.The incidence of complications of the experimental group was lower than that of the control group（P<0.05）.Conclusion：Internal fixation with double vertical plates through different posterior elbow approaches in the treatment of distal humeral type C fracture has a certain clinical effect.However，internal fixation with double vertical plate through triceps muscularis flap approach has a good prognostic effect，and play an important role in improving elbow joint function and range of motion.At the same time，it can also reduce the incidence of complications.It has high clinical value and is worth popularizing.

【Key words】 Olecranon osteotomy approach; Triceps muscularis flap approach; Internal fixation with double vertical plates; Distal humerus type C fracture; Clinical efficacy

First-authors address：Huangmei County Hospital of Traditional Chinese Medicine，Huangmei 435500，China

肱骨远端骨折是肱骨髁上及远部位处的骨折，因解剖结构较为特殊，在治疗中存在一定困难[1]。临床统计表明，肱骨远端C型骨折属于临床最常见的一种骨折类型，且均为关节内骨折，累及双柱，多数需要实施手术治疗[2]。但不同的手术入路，对后肘关节功能的恢复也产生不同的影响。随着医疗技术的不断进步，肱骨远端C型骨折患者多采用钢板置入内固定治疗，取得显著的治疗效果[3]。双垂直钢板置入内固定均采用肘后入路方式，包括尺骨鹰嘴截骨入路、肱三头肌舌肌瓣入路两种，不同的入路方式效果不同[4]。因此，本次研究主要针对不同肘后入路双垂直钢板置入内固定治疗肱骨远端C型骨折的效果进行对比分析，取60例患者开展研究，汇报如下。……