Effects of the bilateral triceps brachii approach and olecranon osteotomy approach in the treatment of type C distal humeral fractures
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摘要: 目的 观察手术治疗肱骨远端C型骨折的2种手术入路的临床疗效。 方法 将40例肱骨远端 C型骨折分为A组和B组。A组采用经肱三头肌两侧入路, B组采用经尺骨鹰嘴截骨入路。采用Mayo肘关节评分标准进行功能评价。 结果 40例患者尺神经损伤1例,无内固定松动、断裂,均骨性愈合。Mayo肘关节评分标准结果显示, A组优良率为75.0%, B组优良率为65.0%, 2组优良率比较差异无统计学意义(P>0.05)。2组切口长度、手术时间、术中出血量差异有统计学意义(P<0.05)。平均随访时间及骨折愈合时间比较,差异无统计学意义(P>0.05)。 结论 2种手术入路治疗肱骨远端C型骨折并结合术后早期功能锻炼,疗效均较好。对于骨折粉碎程度高、关节面损伤重的C3型骨折,优先考虑尺骨鹰嘴截骨入路。Abstract: Objective To observe the clinical efficacy of two surgical approaches in the treatment of type C distal humeral fractures. Methods A total of 40 patients with type C fractures of distal humerus were divided into group A and group B. The group A treated by bilateral triceps brachii approach, while the group B treated by olecranon osteotomy approach. The function was evaluated by the Mayo Elbow Performance Score. Results Out of 40 cases, ulnar nerve was injured in 1 case, and there was no loosening or fracture of internal fixation, all of them had bone healing. The Mayo Elbow Performance Score showed that the excellent rate in the group A was 75.0%, and 65.0% in group B, there was no significant difference between the two groups(P>0.05). There were statistically significant differences in incision length, operation time and intraoperative bleeding between the two groups(P<0.05). There were no statistically significant differences in average follow-up time and fracture healing time(P>0.05). Conclusion Two surgical approaches for distal humerus type C fractures combined with early postoperative functional exercise show good efficacy. Olecranon osteotomy approach is a preferred option for severe C3-type comminuted fracture and articular surface damage.
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Keywords:
- distal humerus /
- osteotomy /
- olecranon /
- operative approach
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