摘要
目的 :探讨肱骨小头骨折治疗方法及疗效。方法 :1992年 8月～ 2 0 0 0年 7月收治肱骨小头骨折 2 5例 ,MehdianⅠ型 16例 ,Ⅱ型 4例 ,Ⅲ型 2例 ,Ⅳ型 3例。其中 ,Ⅱ型 4例、Ⅲ型 1例行骨折碎片切除 ,其余 2 0例行切开复位、内固定 (AO中空松质骨螺钉加压固定 9例 ,BIOFIX可吸收螺钉固定 11例 ) ,术后 2 4～ 48小时即行肘关节功能锻炼。对所有病例均行X线及肘关节功能随访 ,随访 8～ 96个月 (平均 2 2个月 )。结果 :骨折碎片切除组 5例 ,4例Ⅱ型骨折肘关节功能均良好 ,屈 130～ 15 0°,伸 0～ 2 0°;1例Ⅲ型骨折功能稍差 ,肘关节屈 12 0°,伸30° ,劳累后偶有酸胀痛。内固定组骨愈合时间为 6～ 9周 (平均 7周 )。肘关节功能恢复良好 ,屈 12 0～ 15 0° ,伸 0～ 40°,前臂旋转功能基本正常 ,无疼痛及骨片缺血坏死等并发症。 1例Ⅲ型骨折行切开复位内固定术后肘关节继发骨化性肌炎 ,僵直于功能位。另 1例Ⅳ型骨折肘关节功能恢复较差 ,屈 10 0° ,伸 6 0°。结论 :解剖复位、牢固固定、患肘早期活动是肱骨小头骨折功能恢复良好的前提。对于Ⅱ型骨折的软骨片及Ⅲ型粉碎骨折的小碎片难以内固定者 ,宜行手术切除 ,早期功能锻炼。
Objective:To elucidate the ways and effect of treatment on capitellar fractures.Methods:Twenty-five patients with capitellar fractures were treated from August 1992 to July 2000(type I or Hahn-Steinthal fracture 16,type Ⅱ or Kocher-Lorenz fracture 4,type Ⅲ 2,type Ⅳ 3).Five patients(type Ⅱ 4,type Ⅲ 1)were managed with surgical resection of small fragments.Twenty patients were treated with open reduction,internal fixation and early motion of the elbow.The average duration of follow-up was twenty-two months(range,8 to 96 months).Results:The fracture united at an average of seven weeks(range,6 to 9 weeks).Flexion of the elbow in twenty-three patients was from 130～150°,extension 0～40°,protation and supination of the forearm normal.Conclusion:The principles of management of capitellar fractures are similar to any other intra-articular fracture.Accurate anatomic reduction,rigid internal fixation,and early mobilization of the elbow are prerequisites for a good functional result.Small fragments with minimal subchondral bone,not amenable to rigid internal fixation,are best treated by surgical resection.
出处
《华西医学》
CAS
2001年第2期199-201,共3页
West China Medical Journal
