Zhang Lihai, Hu Fangke, Zhang Licheng, Chen Hua, Xu Meng, Wang Yan, Tang Peifu
Department of Orthopaedics, General Hospital of Chinese PLA, Beijing, 100853, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Dec;24(12):1409-12.
To evaluate the effectiveness of the AO anatomical locking compression plate in treating type C distal humeral fracture.
Between July 2008 and April 2009, 13 cases of type C distal humeral fracture were treated with the AO anatomical locking compression plates. There were 5 males and 8 females with an average age of 52.1 years (range, 24-80 years). Fractures were caused by tumbling in 7 cases, by traffic accident in 4 cases, and by falling from height in 2 cases. According to Association for Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification, there were 3 cases of type C1, 6 cases of type C2, and 4 cases of type C3. Two cases complicated by ulnar nerve injuries, 1 by radial nerve injury, 2 by fractures of ulnar olecranon, 3 by fractures of other parts of extremities, and 6 by osteoporosis. The time from injury to hospitalization ranged from 3 hours to 4 days (0.9 day on average).
All the incisions achieved healing by first intention. Thirteen cases were followed up 12 to 21 months with an average of 15.9 months. According to the X-ray films, unions were achieved both at fracture site and the olecranon osteotomy site with a healing time of 8 to 13 weeks (10 weeks on average). The function of elbows recovered from 3 to 32 weeks (10 weeks on average). No fixation failure, myositis ossificans, delayed union, or malunion occurred during the follow-up. The Mayo Elbow Performance score ranged from 75 to 100 with an average score of 95.8; the results were excellent in 9 cases, good in 3 cases, and fair in 1 case with an excellent and good rate of 92.3%.
The AO anatomical locking compression plate has a good fixation in treating type C distal humeral fracture. Through the approach of olecranon osteotomy, it is easy to get anatomical reduction, stable fixation, and early exercise.
评估AO解剖型锁定加压钢板治疗C型肱骨远端骨折的有效性。
2008年7月至2009年4月，采用AO解剖型锁定加压钢板治疗13例C型肱骨远端骨折。其中男性5例，女性8例，平均年龄52.1岁（范围24 - 80岁）。骨折原因：摔伤7例，交通事故伤4例，高处坠落伤2例。按照骨科学会/骨科创伤协会（AO/OTA）分类，C1型3例，C2型6例，C3型4例。合并尺神经损伤2例，桡神经损伤1例，尺骨鹰嘴骨折2例，其他部位肢体骨折3例，骨质疏松6例。受伤至住院时间为3小时至4天（平均0.9天）。
所有切口均一期愈合。13例患者随访12至21个月，平均15.9个月。X线片显示骨折部位及鹰嘴截骨部位均愈合，愈合时间为8至13周（平均10周）。肘关节功能恢复时间为3至32周（平均10周）。随访期间未发生内固定失败、骨化性肌炎、延迟愈合或畸形愈合。Mayo肘关节功能评分75至100分，平均95.8分；优9例，良3例，可1例，优良率92.3%。
AO解剖型锁定加压钢板治疗C型肱骨远端骨折固定效果良好。经鹰嘴截骨入路，易于实现解剖复位、稳定固定及早期功能锻炼。
