夏文强 罗震宇 尹博

[摘要] 目的 探讨经肱三头肌两侧入路治疗成人肱骨远端粉碎骨折的治疗效果。 方法 2004年4月～2010年8月，采用经肱三头肌两侧入路，Y形钢板或双钢板内固定治疗成人肱骨远端粉碎骨折31例。 结果 随访1～2.5年，平均1.6年，按Aitken和Rorabeek标准进行功能评定，优18例，良8例，可5例，差0例，优良率为83.9%。 结论 经肱三头肌侧方入路，应用Y形钢板或双钢板内固定，治疗肱骨远端骨折粉碎骨折，具有创伤小、固定坚强可靠等优越性，利于肘关节早期功能锻炼。

[关键词] 肱骨远端骨折；经肱三头肌两侧入路；骨折固定术；内固定

[中图分类号] R683.41[文献标识码] A[文章编号] 1674-4721（2012）07（c）-0073-02

Treatment of adult distal humeral crushing fracture through the both sides of musculus triceps brachii

XIA Wenqiang LUO Zhenyu YINBo

Beijing Fengtai Hospital, Beijing 100070, China

[Abstract] Objective To explore the therapeutic effect of adult distal humeral crushing fracture through the both sides of musculus triceps brachii. Methods Thirty one cases of adult distal humeral crushing fracture from April 2004 to August 2010 were given the treatment of the fixation of "Y"-shaped pattern plate or bilateral plate through the both sides of musculus triceps brachii. Results The followed-up time were 1-2.5 years, the average was 1.6 years. The functional evaluation was done according to Aitken and Rorabeek standard, excellent in 18 cases, good in 8 cases, acceptable in 5 cases and bad in 0 case. The excellent and good rate was 83.9％. Conclusion The application of "Y"-shaped pattern plate or bilateral plate fixation to treat distal humeral crushing fracture through the both sides of musculus triceps brachii has the superiority of small trauma, fixed strong and reliable, and is benefit for the early functional exercise of elbow.

[Key words] Distal humeral fracture; Through the both sides of musculus triceps brachii; Fracture fixation; Internal fixation

成人肱骨遠端骨折多为高能量伤，骨折及软组织损伤往往并存。特别是涉及关节面的骨折多为粉碎性，由于关节面完整性被破坏，骨折处骨皮质薄、关节面构造复杂的解剖特点，闭合复位难达到理想的效果，也易出现再移位。以往因手术入路及内固定方式选择不合理，继而影响患者早期功能锻炼，出现肘关节功能障碍，骨折对位对线差、骨不连的情况并不少见。本院2004年4月～2010年8月共收治肱骨远端关节内粉碎骨折患者31例，均行经肱三头肌两侧入路，切开复位内固定，内固定方法包括Y形钢板或双钢板，31例均获得随访，现报道如下：

1资料与方法

1.1一般资料

本组共31例，男17例，女14例，年龄最小24岁，最大69岁，平均47岁。均为新鲜闭合骨折，其中摔伤16例，高处坠落5例，车祸10例，合并桡神经损伤3例，尺神经损伤1例。骨折类型按AO/ASIF分类均为C型骨折，其中C1型14例，C2型9例，C3型8例。……