| 龚 立,王延鹤,孔令超,成金磊,吕飞飞,王叙进,朱万博.尺骨鹰嘴截骨和内外侧入路非截骨入路治疗肱骨髁间骨折的效果比较分析[J].,2020,(18):3563-3566 |
| 尺骨鹰嘴截骨和内外侧入路非截骨入路治疗肱骨髁间骨折的效果比较分析 |
| Comparative Analysis of the Effect of Olecranon Osteotomy and Medial and Lateral Non-osteotomy in the Treatment of Humeral Intercondylar Fracture |
| 投稿时间：2020-02-15 修订日期：2020-03-12 |
| DOI：10.13241/j.cnki.pmb.2020.18.037 |
| 中文关键词: 尺骨鹰嘴截骨 内外侧入路 肱骨髁间骨折 效果 并发症 |
| 英文关键词: Olecranon osteotomy Internal and external approaches Humeral intercondylar fracture Effect Complications |
| 基金项目:国家卫生计生委医药卫生科技发展研究中心项目（W2015QJ062） |
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| 中文摘要: |
| 摘要 目的：比较尺骨鹰嘴截骨和内外侧非截骨入路治疗肱骨髁间骨折的效果。方法：前瞻性选取2016年9月至2018年9月在本院进行治疗的76例肱骨髁间骨折患者作为研究对象，按照数字表法随机分为截骨组和非截骨组各38例，截骨组采用尺骨鹰嘴截骨入路进行治疗，非截骨组采用内外侧入路非截骨入路进行治疗。比较两组患者手术时间、术中出血量、术后24 h出血量、X线暴露时间，术后12个月骨折延迟愈合、尺神经麻痹、关节挛缩、骨关节炎等并发症的发生率以及疗效。结果：截骨组手术时间、术中出血量、术后24 h出血量、X线暴露时间明显低于非截骨组，差异均有统计学意义（P<0.05）。截骨组并发症的发生率为13.16%，非截骨组并发症发生率为26.32%，两组比较差异无统计学意义（P>0.05）。截骨组优良率为84.21%，非截骨组优良率为71.05%，两组比较差异无统计学意义（P>0.05）。截骨组C1、C2、C3型肱骨髁间骨折术后肘关节评分优良率分别为78.57%、88.23%、85.71%，非截骨组C1、C2、C3型肱骨髁间骨折术后肘关节评分优良率分别为86.66%、73.33%、62.50%，非截骨组C1型肱骨髁间骨折术后肘关节评分优良率略高于截骨组，截骨组C2、C3型肱骨髁间骨折术后肘关节评分优良率略高于非截骨组，但两组不同AO分型优良率比较差异无统计学意义（P>0.05）。结论：肱骨髁间骨折患者应用尺骨鹰嘴截骨入路手术较肱三头肌内外侧非截骨入路手术具有一定的临床优势，可显著减少手术时间、术中出血量、术后24h出血量以及术中X线照射时间，并且术后肘关节功能恢复较好，在粉碎较为严重的C2、C3型肱骨髁间骨折中推广使用。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effect of olecranon osteotomy and lateral non-osteotomy in the treatment of humeral intercondylar fracture. Methods: 76 cases of humeral intercondylar fracture treated in our hospital from September 2016 to September 2018 were prospectively selected as the research objects. According to the method of digital table, they were randomly divided into osteotomy group and non osteotomy group, 38 cases each. Osteotomy group was treated by olecranon osteotomy, non osteotomy group by lateral non-osteotomy. The operative time, intraoperative bleeding volume, 24h postoperatively bleeding volume, X-ray exposure time,the incidence and effect of complications such as delayed union of fracture, ulnar nerve paralysis, joint contracture and osteoarthritis 12 months after operation and effect were compared between the two groups. Results: The operation time, intraoperative bleeding volume, 24h postoperatively bleeding volume and X-ray exposure time of osteotomy group were significantly lower than those of non osteotomy group (P<0.05). The incidence of complications was 13.16% in osteotomy group and 26.32% in non osteotomy group, there was no significant difference between the two groups (P>0.05). The excellent and good rate of osteotomy group was 84.21%, and that of non osteotomy group was 71.05%, there was no significant difference between the two groups (P>0.05). The excellent and good rate of elbow joint score after operation of C1, C2 and C3 humeral intercondylar fracture in osteotomy group was 78.57%, 88.23% and 85.71%,the excellent and good rate of elbow joint score after operation of C1, C2 and C3 humeral intercondylar fracture in non osteotomy group was 86.66%, 73.33% and 62.50% respectively. The excellent and good rate of elbow joint score after operation of C1 humeral intercondylar fracture in non osteotomy group was slightly higher than that in osteotomy group, and the excellent and good rate of elbow joint score after operation of C2 and C3 humeral intercondylar fracture in osteotomy group was slightly higher than that in osteotomy group, but there was no significant difference between the two groups (P>0.05). Conclusion: The operation of olecranon osteotomy for the treatment of humeral intercondylar fracture has certain clinical advantages over the operation of internal and external lateral non-osteotomy of triceps of humerus.It can significantly reduce the operation time, ntraoperative bleeding volume, 24h postoperatively bleeding volume and intraoperative X-ray irradiation time, and the elbow joint function recovers well after operation.It is widely used in C2 and C3 humeral intercondylar fracture with severe comminution. |
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