Liu Ya-Ke, Xu Hua, Liu Fan, Wang You-Hua, Tao Ran, Cao Yi, Wang Hong, Zhou Zhen-Yu, Zhu Yong
Department of Orthopaedics, the Affiliated Hospital of Nantong University, Nantong, China.
Zhonghua Wai Ke Za Zhi. 2009 Jun 15;47(12):892-5.
To evaluate the clinical outcome of dual plating in the treatment of humeral intercondylar type-C fractures in adults.
From June 2004 to October 2007, 38 cases of type-C distal humeral fractures were stabilised with dual plating. There were 21 males and 17 females. The average age was 43 years with a range from 21 to 71 years. According to the AO classification, 9 cases were of type C1, 17 of C2 and 12 of C3. The posterior midline approach was selected. Twenty-one cases were exposed through the trans-olecranon osteotomy, 11 through the Campbell (Van Gorder) approach, 6 through triceps sparing approach. Autogenous bone graft was performed in 5 cases because of severe comminution.
Thirty-five patients were followed-up for 14-30 months (mean 24.2 months). At the latest follow-up, the elbow flexion averaged 119 degrees (range 90 degrees - 135 degrees ), and the loss of extension averaged 16.2 degrees (range 5 degrees - 25 degrees ). All the patients got bony healing, the average healing period was 14 weeks. The patients were evaluated using the criteria of Aitken and Rorabeek and the scores were 13 excellent, 16 good, 6 fair. Twenty-nine patients (82.9%) had a good or excellent results. Complications included 4 cases of traumatic osteoarthritis, 2 heterotopic ossification, 1 ulnar neuropathy. Infection as well as loosening or breakage of the implant was not found.
The dual plating is able to provide rigid fixation for the humeral intercondylar fractures. In addition, it can allow early functional exercise after operation, decrease the related complications significantly, and improve the functional results.
评估双钢板固定治疗成人肱骨髁间C型骨折的临床疗效。
2004年6月至2007年10月，采用双钢板固定治疗38例C型肱骨远端骨折。其中男性21例，女性17例。平均年龄43岁，年龄范围为21至71岁。根据AO分类，C1型9例，C2型17例，C3型12例。采用后正中入路。21例经鹰嘴截骨显露，11例经坎贝尔（范戈德）入路，6例经保留肱三头肌入路。5例因严重粉碎性骨折行自体骨移植。
35例患者获随访14至30个月（平均24.2个月）。末次随访时，肘关节平均屈曲119度（范围90度至135度），伸直丧失平均16.2度（范围5度至25度）。所有患者均获骨性愈合，平均愈合时间为14周。采用艾特肯和罗拉贝克标准对患者进行评估，结果为优13例，良16例，可6例。29例（82.9%）患者结果为优良。并发症包括创伤性骨关节炎4例，异位骨化2例，尺神经损伤1例。未发现感染以及内固定松动或断裂。
双钢板可为肱骨髁间骨折提供坚强固定。此外，术后可早期进行功能锻炼，显著减少相关并发症，改善功能结果。
