McKee W M, Macias C, Innes J F
Willows Referral Service, 78 Tanworth Lane, Solihull, West Midlands B90 4DF.
J Small Anim Pract. 2005 May;46(5):217-26. doi: 10.1111/j.1748-5827.2005.tb00313.x.
To describe bilateral fixation of Y-T fractures of the humeral condyle via combined medial and lateral approaches, and to determine the technique's clinical and radiographic short-term outcomes.
Details of 30 consecutive fractures in 29 dogs were reviewed. These included signalment, method of fixation, complications, and follow-up limb function and range of elbow joint motion.
The age of the dogs ranged from three months to nine years, and bodyweight ranged from 1.9 to 48 kg. The humeral condyle was reattached to the shaft using medial and lateral bone plates in 18 fractures, a medial plate and lateral Kirschner wire(s) in six fractures, and medial and lateral Kirschner wire(s) in six fractures. Major complications were recorded in four fractures and minor complications in two fractures. Limb function at follow-up was graded as excellent in 12, good in 15 and fair in three fractures. The range of elbow flexion was normal in seven, mildly reduced in 18, moderately reduced in four and severely reduced in one fracture.
In contrast to the caudal approach, combined medial and lateral approaches decrease the extent of periarticular soft tissue dissection, avoid complications associated with olecranon osteotomy and enable exposure of the entire humeral diaphysis for fixation. Bilateral fixation is likely to be better at counteracting bending and torsional forces compared with unilateral fixation.
描述通过内侧和外侧联合入路对肱骨髁Y型骨折进行双侧固定,并确定该技术的临床和影像学短期疗效。
回顾了29只犬连续30处骨折的详细情况。这些包括特征、固定方法、并发症以及随访时的肢体功能和肘关节活动范围。
犬的年龄从3个月到9岁不等,体重从1.9千克到48千克。18处骨折采用内侧和外侧接骨板将肱骨髁重新连接至骨干,6处骨折采用内侧接骨板和外侧克氏针,6处骨折采用内侧和外侧克氏针。4处骨折记录有主要并发症,2处骨折有 minor 并发症。随访时肢体功能评定为优12处,良15处,可3处骨折。肘关节屈曲范围正常7处,轻度减小18处,中度减小4处,重度减小1处骨折。
与后路入路相比,内侧和外侧联合入路减少了关节周围软组织的剥离范围,避免了与鹰嘴截骨相关的并发症,并能够暴露整个肱骨干以进行固定。与单侧固定相比,双侧固定在抵抗弯曲和扭转力方面可能更好。