两种方法治疗肱骨远端C型骨折疗效比较分析

摘要

目的 分析比较肱骨远端C型骨折行铰链式外固定支架结合有限内固定与双钢板内固定治疗的临床疗效.方法 将46例肱骨远端复杂骨折患者分成两组:A组19例采用铰链式外固定支架结合有限内固定治疗,B组27例采用双侧重建钢板固定治疗.随访1.5～2年,调查骨折愈合时间及并发症情况.结果 外固定架组的骨折愈合时间要早于内固定组,两组病例的肘关节功能差异无统计学意义,外固定架组的异位骨化率要明显低于内固定组.结论 铰链式外固定支架结合有限内固定及双钢板内固定治疗肱骨远端复杂骨折临床疗效满意,都是治疗肱骨远端复杂骨折的有效方法;但在骨折愈合时间及异位骨化的发生率方面,外固定架结合有限内固定治疗方法要优于双钢板内固定治疗.%Objective To Compare the efficacy of limited internal fixation combined with hinged super-articular external fixation with intemal fixation with two reconstruction plates in the treatment of type C fractures of the distal humerus. Methods 46 patients were randomly divided into two groups. 19 patients were treated with limited internal fixation combined with hinged super-articular external fixation, and 27 patients with two reconstruction plates.Fracture union time, Cassebaum elbow function score, the rate of complications were evaluated, the mean follow-up time is 14 months. Results Fracture union time was earlier in external fixation group than that in internal fixation group. The rate of heterotopic ossification was lower in the external fixator group than that in the internal fixation group, with no significant difference in elbow function. Conclusion Two methods are both useful and effective techniques in the management of type C fractures of the distal humerus, but limited internal fixation with hinged super-articular external fixation is less invasive and superior on fracture union time and the rate ofheterotopic ossification