Celli Andrea, Donini Maria Teresa, Minervini Claudio
Dipartimento di Ortopedia e Traumatologia, Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy.
Chir Organi Mov. 2008 Feb;91(2):57-64. doi: 10.1007/s12306-007-0022-3. Epub 2008 Mar 3.
Open reduction and internal fixation is the treatment of choice in distal humerus fractures. The aims of the treatment are to obtain anatomic reconstruction and restoration of the elbow's geometry followed by stable internal fixation that allows immediate rehabilitation. The plates are pre-contoured to fit the natural anatomy of the elbow and in the case of complex fractures they provide a guide for the anatomic restoration of the distal humerus. The two plates are placed parallel with the screws locked together by interdigitation creating a fixed angle in the distal fragments that provides stability to the entire distal humerus. Using this method we obtained good results according to the Mayo Elbow Performance Score (MEPS) and we are able to reduce the incidence of complications. Our experience shows also that it can be useful to obtain an anatomical reduction of distal humeral fractures using the pre-contoured plates in a parallel position recovering the anatomical antiversion of the articular surface.
切开复位内固定是肱骨远端骨折的首选治疗方法。该治疗的目的是实现解剖重建和恢复肘关节的几何形态，随后进行稳定的内固定，以便立即进行康复治疗。钢板预先塑形以适应肘关节的自然解剖结构，对于复杂骨折，它们为肱骨远端的解剖复位提供指导。两块钢板平行放置，螺钉通过交叉锁定在一起，在远端骨折块中形成一个固定角度，为整个肱骨远端提供稳定性。根据梅奥肘关节功能评分（MEPS），使用这种方法我们取得了良好的效果，并且能够降低并发症的发生率。我们的经验还表明，使用平行放置的预塑形钢板实现肱骨远端骨折的解剖复位，恢复关节面的解剖反倾角可能是有用的。
