Y形钢板加松质骨螺钉固定和尺神经前置治疗肱骨髁间骨折
Y形钢板加松质骨螺钉固定和尺神经前置治疗肱骨鳏间骨折 Y形钢板加松质骨螺钉固定和尺神经前置治疗肱骨联间骨折 【摘要】目的:评价Y形钢板加松质骨螺钉固定及常规尺神经 前置治疗肱骨髅间骨折的疗效。方法:2003年7月〜2006年6月, 采用Y形钢板加松质骨螺钉固定及常规尺神经前置的方式手术治疗 肱骨联间骨折31例。随访资料完整27例,男21例,女6例;年龄 16〜72岁,平均39岁。肱骨骤间骨折按A0/ASIF分型:C1型17例, C2型8例,C3型2例。除3例合并尺骨鹰嘴骨折经后侧骨折端入路, 其余均采用Campbel 1后侧入路。术后早期肘关节CPM功能练习。结 果:随访6〜27个月,平均11. 8个月,按Cassebaum方法评价疗效: 优16例,良8例,可3例。优良率88. 9%o 3例术前尺神经挫伤随访 8个月,1例神经功能恢复不全,另2例均完全恢复。肘关节功能良 好。结论:肱骨骨果间骨折应尽早解剖复位,尺神经前置可有效减少神 经麻痹的发生,对于术前有尺神经挫伤者也有利于神经功能恢复。坚 强的固定便于早期功能锻炼,有助于肘关节功能恢复。 【关键词】Y形钢板;松质骨螺钉;肱骨骤间骨折;尺神经前置; 早期功能锻炼 文章编号:1009-5519 (2007) 22-3332-03中图分类号:R6文 献标识码:A The curative effects of humeral intercondylar fracture treated with Y shape plate and spongy bone screw internal fixation and anterior transposition of the ulnar nerve LT De-bin, LUO Mei (Department of Orthopedics, The Second People s Hospitai of Panzhihua, Panzhihua 617068, China) [Abstract] 0bjective:The retrospective analysis was carried out to uate the curative effects of humeral intercondylar fracture treated with Y shape plate and spongy bone screw internal fixation accompanied by anterior transposition of the ulnar nerve. s: From July 2003 to June 2006,thirty-one patients diagnosed as humeral intercondylar fracture were treated in our hospital, twenty-seven of which were followed up and uated. By AO/AS IF classification, there was type Cl in 17 cases, type C2 in 8 cases, and type C3 in 2 cases. There were 21 male and 6 female patients with an average of 39 years ranging from 16 to 72 years.They were treated with open reduction, Y shape plate and spongy bone screw internal fixation combined with routine anterior transposition of ulnar nerve.The early CPM mobilization was pered in all patients. Results: The mean follow-up of this group was 11.8 months ranging 6 to 27 months. The outcome was uated with cassebaum, 16 of which were regarded as excellent, 8 cases as good,3 cases as fair, as a result,the elbow function was excellent to good in 88. 9%. The preoperative ulnar nerve injury was diagnosed in 3 cases, and was followed up for 8 months. One case recovered poorly, two cases recovered we11 the elbow function was good. Small scope heterotopic ossification which was in the far end of the brachial triceps developed in one cases associated with cerebral injury 5 weeks after operation, the elbow function was good. Conclusion: Intercondylar fracture of the distal humerus should be treated surgically as early as possible. Routine anterior transposition of the u 1 nar nerve may be helpful to reduce the incidence of delayed ulnar nerve palsy and recover the preoperative ulnar nerve injury, rigid fixation is helpful to early rcise and recover the elbow function. [Key words] Y shape plate; Spongy bone screw; Humeral intercondylar fracture; Anterior transposition of the ulnar nerve; Ear1y rcise 肱骨散间骨折由于其局部的解剖特点及肘关节的生理功能(肘关 节缺乏骨性阻挡,肱骨远端骨质形态扁薄,肱骨小头-滑车复合体向 前凸出,与肱骨干有35〜45度前倾角。肘关节仅有一个关节腔,生理 上具有两种不同功能),预后较差,往往留下肘关节功能障碍,一直 是创伤骨科较难治疗的骨折之一。而早期的解剖复位,牢固内固定和 早期的功能锻炼是治疗