【摘要】 目的比较肱三头肌两侧入路与尺骨鹰嘴截骨入路治疗老年肱骨髁间骨折的疗效差异。方法采用回顾性研究方法,收集我院2011年8月至2016年8月的老年肱骨髁间骨折41例(年龄>65岁)。根据手术方法不同分为肱三头肌两侧入路组(n=22)和尺骨鹰嘴截骨入路组(n=19)。比较2组患者手术时间、术中出血量以及术后12个月的肘关节屈伸活动度及旋转活动度、mayo肘关节功能评分、肘关节Broberg-Morrey评分。结果 41例均获得随访12个月。在手术时间、术中出血量、术后12个月肘关节屈伸活动度及旋转活动度、mayo肘关节功能评分、肘关节Broberg-Morrey评分方面,2组差异均无统计学意义(P<0.05)。但肱三头肌两侧入路组中有异位骨化患者3例,1例术后出现尺神经损伤症状,术后予以对症处理,术后半年神经症状完全消失。尺骨鹰嘴截骨组中有异位骨化患者7例。结论对于肱骨髁间骨折,应首先考虑选择经肱三头肌两侧入路,而对于粉碎程度高的C3型骨折,可选择尺骨鹰嘴截骨入路,但应尽量选择张力带钢丝固定尺骨鹰嘴,减少内固定物对肘关节软组织的激惹。临床技术熟练的情况下仍优先选择经肱三头肌两侧入路。更多还原

【Abstract】 Objective To compare the curative effect of the surgical approach between both sides of triceps and ulna olecranon osteotomy on intercondylar fractures of humerus in elderly patients. Methods The data of patients over 65 years old with intercondylar fractures of humerus from August 2011 to August 2016 were collected. The patients were divided into two groups based on the surgical approach. One group was used the road of both sides of triceps(n=22) and the other was olecranon osteotomy(n=19). The surgery time, the volume of bleeding in operation, the elbow Mayo scores, and Broberg-Morrey scores were recorded. Results All the 41 patients were followed-up for 12 months. There was no significant difference between the two groups on surgery time, the volume of bleeding in operation, the elbow Mayo scores and Broberg-Morrey scores(P<0.05). However, 3 heterotopic ossification occurred in the 22 patients with the approach of both sides of triceps and 7 in the other group. Ulnar injury symptom occurred in one case in the group of both sides of triceps and the symptom disappeared half year by treatment. Conclusion We support that the road of both sides triceps is the first choice in the management of intercondylar fractures of humerus. Even for the C3 fracture, both sides triceps can still be used.更多还原