Tian Wei, He Chao, Jia Jian
Department of Traumatic Orthopaedics, Tianjin Hospital of China, Tianjin Medical University Tianjin 300211, China.
Tianjin University of Traditional Chinese Medicine Tianjin 300211, China.
Int J Clin Exp Med. 2015 Jun 15;8(6):10066-73. eCollection 2015.
To analyze the outcomes of total elbow arthroplasty in the treatment of elderly type C distal humeral fractures and discuss the clinic efficacy.
8 cases of elderly type C distal humeral fractures, Male was in one case, female in seven cases, and the average age was 66.5 years (60-81). All cases were closed fractures because of falling and none had associated injuries. According to AO classification, type C1 were in one cases, C2 in four cases and C3 in three cases. The average time from injury to operation was 5.5 days (3-9), and the type of prosthesis which all cases replaced was Coonrad-Marrey. The postoperative follow-up was obtained regularly which the contents included Mayo elbow score, pain evaluation, the motion range and the stability of the elbow, muscle strength, examination of related complications such as heterotopic ossification, prosthesis loosening and nerve damage.
The incision infection was in one case, ulnar nerve symptom in two cases, weakness of musculus triceps brachii in one case and mild pain of elbow in two cases. The average motion rage of elbow was 103.5±3.2 degree (78-118) in flexion-extension and 126.4±4.1 degree (94-148) in rotation. All elbow joints were stable postoperatively, no prosthesis loosening and apparent wear was found. The heterotopic ossification was found in 1 case. The average Mayo elbow score was 85.2±3.4 (75-95), four cases of excellent and four cases of good.
The total elbow arthroplasty was recommended in clinic to treat elderly type C distal humeral fractures because the clinic outcomes are satisfied.
分析全肘关节置换术治疗老年肱骨远端C型骨折的疗效并探讨其临床疗效。
8例老年肱骨远端C型骨折患者,男1例,女7例,平均年龄66.5岁(60 - 81岁)。所有病例均因跌倒致闭合性骨折,无合并伤。按AO分型,C1型1例,C2型4例,C3型3例。受伤至手术平均时间为5.5天(3 - 9天),所有病例均置换Coonrad - Marrey型假体。术后定期随访,内容包括Mayo肘关节评分、疼痛评估、肘关节活动范围及稳定性、肌肉力量,检查异位骨化假体松动及神经损伤等相关并发症。
切口感染1例,尺神经症状2例,肱三头肌肌力减弱1例,肘关节轻度疼痛2例。肘关节屈伸平均活动度为103.5±3.2度(78 - 118度),旋转平均活动度为126.4±4.1度(94 - 148度)。术后所有肘关节均稳定,未发现假体松动及明显磨损。发现异位骨化1例。Mayo肘关节平均评分为85.2±3.4(75 - 95),优4例,良4例。
全肘关节置换术治疗老年肱骨远端C型骨折临床疗效满意,临床推荐应用。