Webb LX
Department of Orthopaedic Surgery, Wake Forest University Medical Center, Winston-Salem, NC.
J Am Acad Orthop Surg. 1996 Nov;4(6):336-344. doi: 10.5435/00124635-199611000-00006.
Distal humeral fractures in adults often pose a challenge to the orthopaedic surgeon. Preoperative planning, minimal devitalization of bone and soft tissue, and adherence to the prerequisites of biomechanical fixation are all important elements in effecting the desired end result. The chevron modification of the olecranon osteotomy affords excellent surgical exposure of the joint surface for fractures with an intra-articular component. When two plates are used to fix the lateral and medial distal humeral columns, it is best to orient them so that, when looked at in cross section, they are at right angles to each other. The achievement and maintenance of an anatomic reduction secure enough to permit early functional, pain-free motion of the elbow can be best ensured by open reduction and internal fixation with careful attention to detail.
成人肱骨远端骨折常常给骨科医生带来挑战。术前规划、尽量减少骨与软组织的失活以及遵循生物力学固定的前提条件，都是实现理想最终结果的重要因素。鹰嘴截骨的人字形改良术能为伴有关节内成分的骨折提供极佳的关节面手术显露。当使用两块钢板固定肱骨远端的外侧和内侧柱时，最好将它们定向，使其在横截面观察时相互成直角。通过切开复位内固定并仔细关注细节，能最好地确保实现并维持足够稳固的解剖复位，以允许肘部早期进行无痛功能活动。
