Throckmorton Thomas W, Zarkadas Peter C, Steinmann Scott P
Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN 55902, USA.
Hand Clin. 2007 Nov;23(4):457-69, vi. doi: 10.1016/j.hcl.2007.09.001.
Fractures of the distal humerus in adults have traditionally presented a treatment challenge for the orthopedic surgeon. The combination of anatomic complexity, multifragmentary comminution, and a short distal segment, often in the setting of osteoporotic bone, renders these fractures difficult to treat successfully and often make a full restoration of function uncertain. Multiple methods of treatment for these fractures have been described, including bracing, internal fixation, hemiarthroplasty, and total elbow arthroplasty. This article reviews the epidemiology and classification of these injuries and the numerous described fixation and arthroplasty techniques. The current treatment algorithm and authors' preferred method of internal fixation are also illustrated. Additionally, the treatment of these injuries in the elderly population and the complications of surgical treatment are reviewed.
成人肱骨远端骨折一直以来都是骨科医生面临的治疗难题。其解剖结构复杂、多块粉碎性骨折以及远端骨段较短,且常伴有骨质疏松,这些因素使得此类骨折难以成功治疗,功能能否完全恢复也往往不确定。针对这些骨折,已有多种治疗方法被描述,包括支具固定、内固定、半关节置换和全肘关节置换。本文回顾了这些损伤的流行病学和分类,以及众多已描述的固定和关节置换技术。还阐述了当前的治疗方案和作者首选的内固定方法。此外,还对老年人群中这些损伤的治疗以及手术治疗的并发症进行了综述。