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《创伤外科杂志》[ISSN:/CN:]

期数:

2020年11期

页码:

840-843

栏目:

短篇论著

出版日期:

2020-11-17

文章信息/Info

Title:

A comparative study of Schildhauer approach and olecranon osteotomy approach in the treatment of type C distal humeral fractures

文章编号:

1009-4237(2020)11-0840-04

作者:

朱广伟; 张大伟; 王 丹; 高虎方; 张新潮

472000 河南 三门峡,三门峡市中心医院骨关节外科(朱广伟,高虎方); 450000 郑州,郑州市骨科医院上肢科(张大伟); 450052 郑州,郑州大学第一附属医院骨一科(王丹); 200540 上海,上海复旦大学附属金山医院骨科(张新潮)

Author(s):

ZHU Guang-wei¹; ZHANG Da-wei²; WANG Dan³; GAO Hu-fang¹; ZHANG Xin-chao⁴

1.Department of Osteoarticular Surgery,Sanmenxia Central Hospital,Sanmenxia,Henan 472000,China; 2.Department of Upper Limb,Zhengzhou Orthopaedic Hospital,Zhengzhou,Henan 450000,China; 3.The First Department of Orthopedics,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China; 4.Department of Orthopedics,Jinshan Hospital Affiliated to Shanghai Fudan University,Shanghai 200540,China

关键词:

肱骨远端骨折;  入路;  复位;  肘关节功能

分类号:

R 683.41

DOI:

10.3969/j.issn.1009-4237.2020.11.010

文献标识码:

A

摘要:

目的 探讨Schildhauer入路与鹰嘴截骨入路复位内固定治疗肱骨远端C型骨折的疗效。方法 前瞻性选取2014年5月—2019年2月三门峡市中心医院骨关节外科收治的150例肱骨远端C型骨折患者,男性67例,女性83例; 年龄33～61岁,平均51.0岁。致伤原因:道路交通伤76例,高处坠落伤38例,平地跌倒36例。患者随机分为两组,鹰嘴截骨入路组(75例)采用鹰嘴截骨入路切开复位内固定治疗,Schildhauer入路组(75例)采用Schildhauer入路切开复位内固定治疗。患者均术后随访1年。比较两组手术相关指标、肘关节功能、生活质量和并发症差异。结果 Schildhauer入路组手术时间、术中出血量少于鹰嘴截骨入路组[(102.56±12.05)min vs.(151.23±13.57)min;(107.25±15.29)mL vs.(132.35±16.35)mL,P<0.05],术后12个月Mayo肘关节功能(MEPS)评分优良率高于鹰嘴截骨入路组(88% vs. 75%,P<0.05),患侧肘关节屈伸、内旋、外旋角度均大于鹰嘴截骨入路组[(125.35±14.62)° vs.(118.23±11.35)°;(91.35±5.32)° vs.(80.32±4.23)°;(91.34±6.35)° vs.(79.42±5.05)°,P<0.05],健康状况调查简表(SF-36)评分均高于鹰嘴截骨入路组[(66.88±11.23)分vs.(55.13±7.13)分,P<0.05]。两组术后住院时间、骨折愈合时间、并发症发生率比较差异无统计学意义(P>0.05)。结论 与鹰嘴截骨入路比较,Schildhauer入路可减少手术创伤,节省手术时间,改善肘关节功能和生活质量,更适合肱骨远端C型骨折的治疗。但对于C3型不截骨,显露和固定有一定困难,临床技术要求较高。

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备注/Memo

备注/Memo:

【基金项目】 2017年河南省医学科技攻关计划项目(201703175)

常用功能

更新日期/Last Update: 2020-11-20