Liu Jun-jian, Ruan Hong-jiang, Wang Jian-guang, Fan Cun-yi, Zeng Bing-fang
Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, Peoples Republic of China.
J Shoulder Elbow Surg. 2009 Jul-Aug;18(4):646-51. doi: 10.1016/j.jse.2008.12.012. Epub 2009 Apr 11.
Although several studies reported good results of open reduction and internal fixation of displaced fracture of the adult distal humerus, few studies have specifically addressed the results of such surgical fixation in osteoporotic bone in the elderly.
This study focused on AO type C fractures in the elderly by using 2 plates for fixation of the lateral and medial columns to reconstruct a stable triangular frame of the distal humerus. The study comprised 35 patients, and 32 were available for final evaluation at a mean follow-up of 24.5 months (range, 14-60 months).
Mayo Elbow Function Score showed 25 patients (78%) achieved an excellent functional result, and 7 (22%) had a good result. No patients were considered to have a fair or poor result. At the final follow-up, the mean range of flexion to extension of the elbow was 22 degrees (range, 10 degrees -40 degrees) to 125 degrees (range, 100 degrees -140 degrees). All fractures united at average of 3.5 months (range, 2.5-5.3 months).
Open reduction and internal fixation using double-columned plating is a useful and effective technique in the management of displaced, comminuted, intra-articular fractures of the distal humerus in elderly patients.
Level 4; Case series, treatment study.
尽管多项研究报告了成人肱骨远端移位骨折切开复位内固定的良好结果，但很少有研究专门探讨老年骨质疏松性骨中这种手术固定的结果。
本研究聚焦于老年患者的AO C型骨折，采用两块钢板分别固定内外侧柱，以重建肱骨远端稳定的三角框架。该研究纳入35例患者，32例患者可进行最终评估，平均随访24.5个月（范围14 - 60个月）。
梅奥肘关节功能评分显示，25例患者（78%）获得了优异的功能结果，7例（22%）获得了良好结果。没有患者被认为结果一般或较差。在末次随访时，肘关节屈伸平均活动范围从22度（范围10度 - 40度）至125度（范围100度 - 140度）。所有骨折平均在3.5个月（范围2.5 - 5.3个月）愈合。
采用双柱钢板切开复位内固定是治疗老年患者肱骨远端移位、粉碎性关节内骨折的一种有用且有效的技术。
4级；病例系列，治疗研究。
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