中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (17): 3189-3192.doi: 10.3969/j.issn.1673-8225.2010.17.038

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

以AO原则置入解剖接骨板固定治疗肱骨髁间骨折37例：一所市级医院骨科 5年病例回顾

覃  鑫，罗克玲，谢  福   

  1. 来宾市人民医院骨科，广西壮族自治区来宾市 546100
  • 出版日期:2010-04-23 发布日期:2010-04-23
  • 作者简介: 覃 鑫，男，1973年生，广西壮族自治区来宾市人，壮族，1999年桂林医学院毕业，主治医师，主要从事脊柱和四肢关节疾病治疗方面的研究。 qin_xin123@163.com

Implantation of bone plate for treating humeral intercondylar fractures in 37 cases under AO principle: A 5-year review of orthopedic department in a city hospital

Tan Xin, Luo Ke-ling, Xie Fu   

  1. Department of Orthopaedics, Laibin People’s Hospital, Laibin  546100, Guangxi Zhuang Autonomous Region, China
  • Online:2010-04-23 Published:2010-04-23
  • About author:Tan Xin, Attending physician, Department of Orthopaedics, Laibin People’s Hospital, Laibin 546100, Guangxi Zhuang Autonomous Region, China qin_xin123@163.com

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摘要：

背景：保守治疗肱骨髁间骨折效果差，关节功能恢复相对于其他部位骨折有较大的差别，主要因为固定时间过长所致。而早期的功能锻炼必须要以坚强的内固定为基础。
目的：观察利用AO原则行解剖接骨板内固定治疗肱骨髁间骨折的效果。
方法：纳入2000-06/2005-11来宾市人民医院骨科收治的肱骨髁间骨折患者37例，行三维CT重建检查后按AO/ASIF分类分型标准：C1型11例，C2型21例，C3型5例。均采用后路鹰嘴截骨入路切开复位后用双侧解剖接骨板内固定，应用常州市康辉医疗器械有限公司的解剖型接骨板。内固定后第1天开始指导患者行手指和腕关节的屈伸活动。拔除引流后1 d开始物理治疗，早期进行肘关节主动功能锻炼。根据骨折的影像资料以及临床随访结果，结合骨折愈合的进展情况，内固定后4周左右逐渐进行轻微的抗力练习，以恢复肌肉的力量。8~12周后可开始逐渐负重。
结果与结论：37例患者中36例获得随访，随访时间为13~26个月，平均19.5个月，骨折均愈合，优良率为91.7%。内固定复位越早功能锻炼越早，则肘关节功能恢复越快越好。提示根据AO原则应用双解剖接骨板治疗肱骨髁间骨折可提供牢固的内固定，有利于早期功能锻炼和功能恢复。

关键词: 肱骨髁间骨折, 双解剖接骨板, 内固定, AO原则, 早期功能锻炼

Abstract:

BACKGROUND: Conservative treatment receives poor results in treating humeral intercondylar fractures, due to the over-long time fixation, and the recovery of joint function would be restricted. Early functional exercises should be based on stable internal fixation.
OBJECTIVE: To explore the effectiveness of bone plate internal fixation in treating humeral intercondylar fractures under AO principle.
METHODS: Totally 37 cases with humeral intercondylar fractures at the Department of Orthopaedics, Laibin People’s Hospital from June 2000 to November 2005 were collected, under AO/ASIF classification, cases were assigned into three groups: type C1 consisted of 11 cases, C2 consisted of 21 cases and C3 comprised 5 cases. All the cases were treated by olecranon osteotomy medial approach open reduction and then treated with dual anatomical plate internal fixation. Flexion and extension activities were done at 1 day after operation. Physical therapy was performed at 1 day after removing drainage. According to the images and clinical follow-up, slightly resistance exercise could be done at 4 weeks after operation, and gradually increased the load after 8-12 weeks. 
RESULTS AND CONCLUSIONS: A total of 36 patients were included in the follow-up with 13-26 months, mean 19.5 months. All the bone fractures were recovered. Earlier operative reduction and exercise function would got better elbow joint recovery. All results demonstrated that dual anatomical plate treatment under AO principle provides firm internal fixation for patients with humeral intercondylar fractures, which is good for early exercise and functional recovery. 

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