双重建钢板内固定治疗肱骨髁间骨折

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1、摘要双重建钢板内固定治疗肱骨髁间骨折研究生：郭欣涛导师：田禾副教授摘要目的：探讨应用双重建钢板内固定治疗肱骨髁间骨折的疗效及分析影响术后肘关节功能恢复的因素。方法：2003年1月～2008年3月手术治疗肱骨髁间粉碎性骨折23例，男14例，女9例，年龄13～58岁，平均36.2岁。左侧9例,右侧14例。按照AO/ASIF分类：C1型6例，C2型9例，C3型8例。其中开放性骨折2例，合并桡神经损伤5例，尺神经损伤4例。所有病例行后路经尺骨鹰嘴截骨或经肱三头肌两侧入路，使用双重建钢板内固定。术后尽早主动行肘关节功能锻炼。结果：23例随访8～38个月，平均14.6个月，骨

2、折均Ⅰ期愈合。术后伤口感染1例，经伤口换药3周愈合；桡神经牵拉损伤1例，经神经营养药物治疗后恢复。根据Cassebaum法评分，优8例，良11例，可4例，优良率82.6％。结论：双重建钢板内固定治疗肱骨髁间骨折是目前治疗肱骨髁间骨折的较好方法。骨折粉碎程度及软组织损伤的严重程度、有效复位及内固定、早期功能锻炼等是影响肘关节功能恢复的主要因素。关键词：肱骨髁间骨折；双重建钢板；内固定术；肘关节—1—新疆医科大学医学硕士学位论文DualreconstructionplatefixationtreatmentofhumeralcondylarfracturePostgr

3、aduate:GuoXintaoSupervisor:Prof.TianHeAbstractObjective:Toinvestigatetheapplicationofdual-reconstructionplatefixationofhumeralcondylarfractureanalysisoftheefficacyandimpactonfunctionalrecoveryafterelbowfactors.Method:FromJanuary2003toMarch2008,23cases(male14,female9)ofhumeralintercond

4、ylarfractureswerereviewed,withanaverageageof36.2years(ranged,13～58years).Leftelbow:9cases;rightelbow:14cases.AccordingtoAO/ASIFclassification,typeC1∶6,typeC2∶9,andtypeC3∶8,2casesofallwereopenfractures.Posterioroperatingapproachofelbow:trans-olecranonosteotomyortrans-triceps-sideapproa

5、chandinternalfixationbystandardmethodofdoubleplateswereperformedinallcases.Thepatientsbegantheactivetrainingofelbowjointassoonaspossiblepostoperatively.Result:Twenty-threecaseswerefollowedupfor8～38monthsandtheaveragetimewas14.6months.Boneunionwasobtainedinallcases.Onecasecomplicatedwo

6、undinfection,itrecoveredafter3weeksofdressing.And1casecomplicatedwithradialnerveinjury,whichrecoveredwithneuralnutrients.AccordingtotheCassebaumscoringsystem,theeffectswereevaluatedasexcellent8,good11,andfair4,andtheexcellent-goodratewas82.6%.Conclusion:Theapplicationofdoubleplateswas

7、provedtobeagoodmethodtotreathumeralintercondylarfracturesatpresent.Buttheseverityofthebonecomminutionandsoft-tissuelesion,theeffectivefixation,earlieractiveexercisewerethemaincausesthatinfluencethefunctionalrecoveryofelbowjoint.Keywords:humeralintercondylarfracture;doubleplates;intern

8、alfix