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平行预塑形钢板在肱骨远端A、C型骨折治疗中的应用

The use of parallel pre-contoured plates in the treatment of A and C fractures of the distal humerus.

作者信息

Rebuzzi Enrico, Vascellari Alberto, Schiavetti Stefano

机构信息

Department of Orthopaedics, Oderzo Hospital, ASL 9 Veneto, Via Luzzatti 33, Oderzo, Treviso, Italy.

出版信息

Musculoskelet Surg. 2010 May;94(1):9-16. doi: 10.1007/s12306-009-0051-1. Epub 2009 Dec 24.

Abstract

The purpose of this study was to retrospectively evaluate the clinical and radiological results of fixation with parallel pre-contoured plates in intra-articular and extra-articular distal humerus fractures. We retrospectively evaluate seven cases of type A and six cases of type C fracture treated with the Mayo Clinic Congruent Elbow Plate system (Acumed, Hillsboro, Oregon) after a mean follow-up of 14.8 and 21.3 months, respectively. Mayo Elbow Performance Score (MEPS) was utilized for functional evaluation. Mean MEPS was (92.86 +/- 16.8) in the first group showing 6 excellent and one poor result, while (94.17 +/- 12) showing five excellent and one fair in the second group, showing no significant difference between the two groups (P = 0.87). The mean active motion recovered postoperatively was 120 degrees (+/-34.5 degrees) in type A fractures and 113 degrees (+/-14.7 degrees) in type C fractures, and there was no significant difference (P = 0.67). Complications occurred in 6 of the 13 patients analysed at follow-up (3 radial neuropathy, one ulnar neuropathy, one screw mobilization and one heterotopic ossification). The fractures healed in every patient, and no synthesis failed. The parallel plate system has proved to be extremely useful in the treatment of intra-articular and extra-articular distal humerus fractures. The pre-contoured geometry allows easier reduction and stabilization of complex fractures. The higher stability achieved permits early mobilization, thus obtaining a higher percentage of excellent results.

摘要

本研究的目的是回顾性评估使用平行预塑形钢板固定治疗肱骨远端关节内和关节外骨折的临床及影像学结果。我们回顾性评估了分别采用梅奥诊所全等肘关节钢板系统(Acumed,俄勒冈州希尔斯伯勒)治疗的7例A型骨折和6例C型骨折,平均随访时间分别为14.8个月和21.3个月。采用梅奥肘关节功能评分(MEPS)进行功能评估。第一组平均MEPS为(92.86±16.8),其中6例优,1例差;第二组平均MEPS为(94.17±12),其中5例优,1例良,两组之间无显著差异(P = 0.87)。A型骨折术后平均主动活动度恢复至120度(±34.5度),C型骨折为113度(±14.7度),两者无显著差异(P = 0.67)。在随访分析的13例患者中,6例出现并发症(3例桡神经病变、1例尺神经病变、1例螺钉松动和1例异位骨化)。所有患者骨折均愈合,无内固定失败情况。平行钢板系统已被证明在治疗肱骨远端关节内和关节外骨折方面极其有用。预塑形的几何形状使复杂骨折的复位和固定更容易。所实现的更高稳定性允许早期活动,从而获得更高比例的优异结果。

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