生物骨科材料与临床研究2017，Vol.14Issue(1)：46-50,5.DOI:10.3969/j.issn.1672-5972.2017.01.012
三角固定技术治疗肱骨远端AO-C型骨折的临床疗效
Clinical effect of triangular fixation technique for treating the distal humerus fractures of AO type C
温干军 1江帝钦 1陈坚 1张史飞 1周树根 1周植森 1滕范文1
作者信息
摘要
Abstract
Objective Distal humerus fractures ofAO typeC are intra-articular and comminuted fractures involving soft tissue injury.As distal humerus is triangle-shaped,parallel plating coupled with articular fixation would be suitable for bicolumn restoration in treatment of distal humerus intercondylar fracture.This study is to evaluated the clinical effect of Triangular Fixation Technique for treating the distal humerus fractures ofAO typeC.Methods This study included 38 patients (15 males and 23 females) who underwent olecranon osteotomy,open reduction and internal fixation with the triangle-shaped cannulated screw and parallel locking plates (triangular fixation technique).Functional results were assessed with the visual analog scale (VAS) scores,Mayo elbow performance (MEP) scores and Disabilities of the Arm,Shoulder and Hand (DASH) questionnaires.Anteroposterior and lateral elbow radiographs were assessed for reduction,alignment,fracture union,posttraumatic arthrosis,and heterotopic ossification,and CT scans were used to obtain more accurate measurements of articular discrepancy.Results All fractures healed primarily with no loss of reduction.The mean VAS,MEP,and DASH scores of the affected elbow were not significantly different from those of the unaffected elbow (P=0.140,P=0.090,and P=0.262,respectively).The mean degree of flexion was significantly lower in the affected elbow than in the unaffected elbow,but was still considered as functional (P=0.001,＞100° in 33 of 38 patients).Two cases of articular step-offs (＞2 mm) were seen on follow-up CT scans,but not significantly higher in the affected elbow than in the unaffected elbow (P=0.657).Binary logistic regression analysis revealed that only Association for Osteosynthesis (AO) type C3 fractures correlated with good/excellent functional outcome (P=0.012).Complications occurred in 12 of the 38 patients,and the overall reoperation rate for complications was 7.89％ (3 of 38 patients).Conclusion Triangular fixation technique for bicolumn restoration was an effective and reliable method in treatment of distal humerus intercondylar fracture.This technique maintained articular congruency and restored both medial and lateral columns,resulting in good elbow function.关键词
三角固定技术/肱骨远端AO-C型骨折/鹰嘴截骨Key words
Triangular Fixation Technique/Distal humeral fractures of AO typeC/Olecranon osteotomy分类
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温干军,江帝钦,陈坚,张史飞,周树根,周植森,滕范文..三角固定技术治疗肱骨远端AO-C型骨折的临床疗效[J].生物骨科材料与临床研究,2017,14(1):46-50,5.
