不同手术方式治疗肱骨远端骨折的疗效观察

目的：探讨不同术式对肱骨远端C型骨折治疗的临床疗效。方法将2012年8月～2013年7月行手术治疗的肱骨远端C型骨折患者49例男性30例，女性19例；年龄22～67岁，平均（37±3.4）岁]分为4组（ A组：肱三头肌劈开入路＋双锁定钢板垂直放置15例； B组：肱三头肌劈开入路＋双锁定钢板平行放置12例； C组：鹰嘴截骨入路＋双锁定钢板垂直放置13例； D组：鹰嘴截骨入路＋双锁定钢板平行放置9例）。术后随访10～21个月，根据肘关节改良Cassebaum评分对骨折愈合时间及肘关节功能进行对比分析。结果4组病例骨折愈合平均时间分别为92、96、102、95d，功能优良率分别为80.0％、83.3％、76.9％、77.8％；4组对比均无统计学意义（P＞0.05），C组出现1例骨延迟愈合，D组出现1例异位骨化。结论不同术式治疗肱骨远端C型骨折的疗效无明显差异，建议根据骨折类型及术者经验选择熟悉的入路及内固定方式。

Clinical efficacy of different surgical methods for the treatment of distal humerus fractures

Objective To explore the clinical efficacy of different surgical methods for the treatment of dis-tal humerus fractures of adults.Methods From Aug.2012 to Jul.2013,49 patients30 males and 19 females aged from 22-67 years with an awerage of (37 ±3.4) years] of distal humerus fracture were treated with perpendicular plate fixation via a triceps-splitting approach(group A,15 cases),parallel plate fixation via a triceps-splitting ap-proach(group B, 12 cases),perpendicular plate fixation via an olecranon osteotomy approach(group C,13 cases), parallel plate fixation via an olecranon osteotomy approach( group D,9 cases) respectively.All patients received 10-21 months of follow-up and Cassebaum functional score was employed to evaluate the treatment results.Results In four groups,the average healing time of fracture were 92,96,98 and 95 days, respectively.The excellent and good rates of function were 80.0%,83.3%,76.9% and 77.8%, respectively.All the data were analyzed with statis-tics.There was no significant difference among groups(P>0.05).Delayed union occurred in one case in group C,and 1 case developed heterotopic ossification in group D.Conclusion As four methods have their own advanta-ges,the clinical choice should be based on the fracture type and the proficiency of the surgical operator.