Department of Orthopaedics, Medical College and Hospital, Kolkata, India.
Int Orthop. 2011 Aug;35(8):1171-7. doi: 10.1007/s00264-010-1122-5. Epub 2010 Dec 12.
Forty-one patients with an intercondylar fracture of the humerus (21 recent and 20 ununited) were treated by total elbow arthroplasty using Baksi's recent version of the sloppy hinge from January 2003 to April 2009. Twelve were AO classification type C2 and nine were type C3 recent closed fractures of seven days' mean duration according to Muller classification. Patient's mean age was 64 years. There were 20 nonunions (nine untreated nonunions of a mean of 11 months duration and 11 following failed internal fixation of a mean of 14 months duration); mean patient age was 58 years. The follow up period was 12-88 (mean 55.5) months. Mean arc of postoperative elbow flexion was 25-130° obtained in 39 (95.1%) patients. Mean arc of 65° pronation and 60° supination was obtained in 33(80.5%) patients. According to the Mayo elbow performance score, in the fresh-fracture group, excellent results were seen in 19 (90.5%), good in one (4.8%), and failure in one (4.8%), whereas in the nonunion group, excellent results were obtained in 17 (85%), good in two (10%), and failure in one (5%). Failure in the two patients was due to deep infection requiring prosthesis removal. Other complications were transient ulnar neurapraxia in three, disassembly of the prosthesis in one, patchy heterotopic ossification in two and localised radiolucency around the flanges of the humeral stem in one.
从 2003 年 1 月至 2009 年 4 月，采用 Baksi 最近版本的松弛铰链对 41 例肱骨髁间骨折（21 例新鲜骨折和 20 例骨不连）患者进行了全肘关节置换。根据 Muller 分类，12 例为 AO 分类 C2 型，9 例为 C3 型新鲜闭合骨折，平均发病时间为 7 天。患者平均年龄为 64 岁。其中 20 例为骨不连（9 例未治疗的骨不连，平均病程为 11 个月，11 例内固定失败，平均病程为 14 个月）；患者平均年龄为 58 岁。随访时间为 12-88 个月（平均 55.5 个月）。39 例（95.1%）患者术后肘关节屈伸弧为 25-130°。33 例（80.5%）患者获得 65°旋前和 60°旋后弧。根据 Mayo 肘关节功能评分，在新鲜骨折组，19 例（90.5%）为优，1 例（4.8%）为良，1 例（4.8%）为失败；在骨不连组，17 例（85%）为优，2 例（10%）为良，1 例（5%）为失败。2 例患者失败的原因是深部感染需要取出假体。其他并发症包括 3 例短暂性尺神经麻痹、1 例假体松动、2 例斑片状异位骨化和 1 例肱骨柄凸缘周围局限性透光区。
