中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (17): 3103-3108.doi: 10.3969/j.issn.1673-8225.2011.17.016

• 骨科植入物 orthopedic implant • 上一篇    下一篇

Y形钢板和双钢板经不同置入途径治疗肱骨髁间骨折的比较

谢志新1，吴  迪2，虢新莲1，农春花1，刘桔慧1，许丽芳1，王  健3   

  1. 1南方医科大学附属深圳宝安区人民医院骨科，广东省深圳市518101
    2深圳宝田医院手外科，广东省深圳市518106
    3深圳宝安区中医院骨科，广东省深圳市518101
  • 收稿日期:2011-01-06 修回日期:2011-02-21 出版日期:2011-04-23 发布日期:2011-04-23
  • 作者简介:谢志新★，男，1967年生，江西省万安县人，汉族，1997年江西南昌大学医学院毕业，硕士，副主任医师，主要从事创伤骨科研究。 xiezx888@126.com

Y-shaped plate versus double plate internal fixation via different inserted ways for treatment of humeral intercondylar fractures

Xie Zhi-xin1, Wu Di2, Guo Xin-lian1, Nong Chun-hua1, Liu Ju-hui1, Xu Li-fang1, Wang Jian3   

  1. 1Department of Orthopedics, Shenzhen Baoan Hospital of Southern Medical University, Shenzhen  518101, Guangdong Province, China
    2Department of Hand Surgery, Shenzhen Baotian Hospital, Shenzhen  518106, Guangdong Province, China
    3Department of Orthopedics, Shenzhen Baoan Hospital of Chinese Medicine, Shenzhen  518101, Guangdong Province, China
  • Received:2011-01-06 Revised:2011-02-21 Online:2011-04-23 Published:2011-04-23
  • About author:Xie Zhi-xin★, Master, Associate chief physician, Department of Orthopedics, Shenzhen Baoan Hospital of Southern Medical University, Shenzhen 518101, Guangdong Province, China xiezx888@126.com

PDF

376

被引次数

30

摘要：

背景：成人肱骨裸间骨折内固定及置入途径选择对置入成功及内固定后功能有明显影响。
目的：比较Y形钢板和双钢板经不同置入途径治疗肱骨髁间骨折疗效的差异。
方法：纳入肱骨髁间骨折患者139例，采用Y形钢板和双钢板两种内固定方式，根据内固定方案分为4组，经尺骨鹰嘴截骨入路44例，经肱三头肌两侧入路46例，经肱三头肌舌状瓣入路27例，经肱三头肌劈开入路22例。随访3个月~2年，根据Aitken和Rorabeck 肘关节功能评定标准对各组患者内固定后肘关节功能进行评定。
结果与结论：双钢板在尺骨鹰嘴截骨组、肱三头肌两侧组和肱三头肌劈开组中优良率优于Y形钢板(P < 0.05)，而在肱三头肌舌状瓣组中优良率差异无显著性意义(P > 0.05)。前3种入路的双钢板固定优良率差异无显著性意义(P > 0.05)，但均比肱三头肌舌状瓣入路双钢板固定优良率高(P < 0.05)。提示肱骨髁间骨折双钢板固定治疗优于Y形钢板固定，尺骨鹰嘴截骨入路、肱三头肌两侧入路和肱三头肌劈开入路可获得相同的临床效果，而且它们的内固定效果均优于肱三头肌舌状瓣入路。

关键词: 肱骨髁间骨折, 内固定, 置入途径, Y形钢板, 双钢板

Abstract:

BACKGROUND: Selection of internal fixation and inserted approach is important to the successful treatment of adult humeral intercondylar fractures.
OBJECTIVE: To review the clinical outcome of Y-shaped plate internal fixation and double plate internal fixation for humeral intercondylar fractures through different operative approaches.
METHODS: Open reduction and internal fixation using plate were performed in 139 cases with humeral intercondylar fracture, of which triceps splitting was carried out in 22, bilateral triceps was carried out in 46, triceps V shaped severance was carried out in 27, and olecranon osteotomy in 44. All patients were followed up for 3-48 months, and the results were scaled according to Aitken and Rorabeck Elbow Score standard. 
RESULTS AND CONCLUSION: The excellent and satisfactory rate of two internal fixation methods showed statistical difference (P < 0.05) by olecranon osteotomy approach, bilateral triceps approach, and triceps splitting approach; while no statistical difference ( P > 0.05) by triceps V shaped severance approach. But the excellent and satisfactory rate of the senior three operative approaches in double plate internal fixation compared with triceps V shaped severance approach showed statistical difference (P  < 0.05), while no statistical difference (P  > 0.05)in comparison with each other. The clinical outcome of humeral intercondylar fractures treated with double plate internal fixation was superior to those treated with Y-shaped plate internal fixation. Meanwhile, triceps splitting approach, olecranon osteotomy approach and bilateral triceps approach can obtain the same clinical outcome for humeral intracondylar fractures, and the clinical outcomes of all three operative approaches are superior to those of triceps V shaped severance approach.

中图分类号: