McCarty L Pearce, Ring David, Jupiter Jesse B
S Harvard Medical School, Boston, Massachusetts, USA.
Am J Orthop (Belle Mead NJ). 2005 Sep;34(9):430-8.
Fractures of the distal humerus are complex injuries that can be effectively treated with open reduction and internal fixation (ORiF). Exposure of a complex intra-articular fracture may best be achieved through a posterior approach with osteotomy of the olecranon process. The ulnar nerve must be identified and protected, the articular surface must be reduced anatomically, and rigid fixation must be applied to both the medial and lateral columns of the distal humerus. Range of motion should be initiated as soon as possible postoperatively. Complications such as ulnar neuropathy, elbow stiffness, heterotopic ossification, and nonunion should be treated aggressively. Total elbow arthroplasty represents an effective option for fractures that cannot be treated with ORIF.
肱骨远端骨折是复杂的损伤，可通过切开复位内固定（ORiF）进行有效治疗。复杂关节内骨折的显露最好通过尺骨鹰嘴截骨的后入路来实现。必须识别并保护尺神经，关节面必须解剖复位，并且必须对肱骨远端的内侧和外侧柱进行坚强固定。术后应尽早开始活动范围训练。对于尺神经病变、肘关节僵硬、异位骨化和骨不连等并发症应积极治疗。对于无法用切开复位内固定治疗的骨折，全肘关节置换是一种有效的选择。
