【作者】 吴成林；

【导师】 刘建国；

【作者基本信息】 吉林大学 ， 外科学， 2008， 硕士

【摘要】 目的:比较不同内固定方法治疗复杂的肱骨髁间骨折的临床疗效。探讨克氏针、Y型钢板、双钢板治疗复杂肱骨髁间骨折的适应症、方法、并发症。资料与方法:我科自2001年10月至2007年12月共收治肱骨髁间C型骨折39例,年龄15-87岁,按AO/ASIF分型均为C型骨折,其中克氏针固定19例,Y型钢板固定6例,双钢板固定10例,非手术的4例.对于手术组的患者均获随访2-24个月,从骨折的愈合时间,并发症,术后临床疗效评价等方面比较。结果:所有病例均获得随访。结果术后疗效采用Aitken和Rorabeek标准进行肘关节功能评定,克氏针固定优良率78.94%,Y型钢板固定优良率83.3%,双钢板固定优良率80%,三者优良率比较(p〉0.05)无显著差异。三者骨折的愈合时间比较无明显差异。仅Y型钢板固定组出现1例慢性感染,经换药及内固定物取出后治愈。结论:克氏针、Y型钢板、双钢板固定对于治疗肱骨髁间骨折均有较高的优良率,可以根据情况选用不同的内固定方式,Y型钢板及双钢板的生物力学特性更适合骨折愈合的需要,而克氏针固定具有花费低,操作简单,创伤小等优点,但其固定稳定性不如Y型钢板及双钢板,不能进行早期关节功能练习。更多还原

【Abstract】 Objective:To evaluate effects of the methods used to treat complicate intercondylar fractures of humeru, and to explore the indication, complication of the methods, which treat the complicate intercondylar fractures of humerus with Kirschner wire, Y shaped plate and double reconstruction plate.Method:From Oct 2001 to Oct 2007, we has treated 39 patients of complicate humeral intercondylar fractures . Age of the patients was ranged 15 to 87 years. All these cases were classified to type C fracture. Among all patients, 19 cases were treated with Kirschner wire,6 cases were treated with Y shaped plate and 10 cases were treated with double reconstruction plate, other 4 cases were treated with nonoperative way. The patients in operation group were followed up for 2 to 24 months, compare the bone healing , complication and clinic effect of different methods. Results: All the patients were followed up. The outcome were evaluated according to Aitken and Rorabeek rating system. The ratio of excellent and good was 78.9% in cases treated with Kirschner wire , 83.3% in cases treated with Y shaped plate and 80.0% in cases treated with double reconstruction plate. The ratio and bone healing of three groups had no significant deviation (p>0.05). Only 1 chronic infection happened in Y shaped plate group, which finally healed well after dislodge of the plate.Conclusion: Treat the complicate intercondylar fractures of humerus with Kirschner wire, Y shaped plate and double reconstruction plate had got good clinical effect. The medical biomechanics character of Y shaped plate and double reconstruction plate was much better for bone healing, but the operation with Kirschner wire was much simple, cheap, and the trauma the operation was less. So we should chose the internal fixation according to specific condition.更多还原