Asfuroğlu Zeynel Mert, İnan Ulukan, Ömeroğlu Hakan
Department Orthopedics and Traumatology, Eskişehir State Hospital, Eskişehir-Turkey.
Ulus Travma Acil Cerrahi Derg. 2018 Mar;24(2):162-167. doi: 10.5505/tjtes.2017.32916.
To investigate the outcomes of patients undergoing open reduction and internal fixation with olecranon osteotomy due to AO type13C fractures of the distal humerus.
Data of 39 patients (mean age, 44.7 years; males, 56.4%) undergoing surgery with the diagnosis of AO type 13C distal humeral fractures were retrospectively evaluated. Patients' demographic characteristics, medical history, and radiological and functional outcomes were recorded. The patients were evaluated at the final follow-up according to the Mayo Elbow Performance Index (MEPI).
The mean degrees of flexion and extension loss were 102.2 degrees (range, 60-120 degrees) and 11.4 degrees (range, 0-25 degrees), respectively, at the final follow-up. According to the MEPI score, outcomes were excellent in seven, good in 12, fair in 13, and poor in seven patients. All patients achieved a radiological union of the fracture site within the first postoperative six months. It was found that the loss of extension was more severe, the range of flexion was decreased, and the mean MEPI score was lower in the patients with type C3 fractures than in those with type C1 and type C2 fractures. No significant difference was determined between fixation techniques (tension band vs. cannulated screw) regarding the functional outcomes.
Our results revealed better prognosis in AO type C1 and type C2 fractures than in AO type C3 fractures and no different effects of two fixation techniques in olecranon osteotomy on the outcomes.
探讨因肱骨远端AO 13C型骨折行鹰嘴截骨切开复位内固定术患者的治疗结果。
回顾性评估39例诊断为肱骨远端AO 13C型骨折并接受手术治疗的患者(平均年龄44.7岁;男性占56.4%)。记录患者的人口统计学特征、病史以及影像学和功能结果。在末次随访时根据梅奥肘关节功能指数(MEPI)对患者进行评估。
末次随访时,平均屈曲和伸展丧失度数分别为102.2度(范围60 - 120度)和11.4度(范围0 - 25度)。根据MEPI评分,7例患者结果为优,12例为良,13例为中,7例为差。所有患者在术后6个月内骨折部位均实现影像学愈合。发现C3型骨折患者的伸展丧失更严重,屈曲范围减小,平均MEPI评分低于C1型和C2型骨折患者。在功能结果方面,固定技术(张力带与空心螺钉)之间未发现显著差异。
我们的结果显示,AO C1型和C2型骨折的预后优于AO C3型骨折,鹰嘴截骨术中两种固定技术对结果的影响无差异。