解剖型锁定接骨板治疗老年骨质疏松性肱骨远端骨折的初步疗效观察
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作者Author单位AddressE-Mail
季滢瑶 JI Ying-yao 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
郑立程 ZHENG Li-cheng 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China zlcheng007@gmail.com 
黄忠胜 HUANG Zhong-sheng 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
李科伦 LI Ke-lun 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
赵政 ZHAO Zheng 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
郑钜晗 ZHENG Ju-han 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
陈志豪 CHEN Zhi-hao 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
倪建光 NI Jian-guang 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,Yueqing Hospital Affiliated to Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
期刊信息:《中国骨伤》2011年,第24卷,第8期,第681-683页
DOI:10.3969/j.issn.1003-0034.2011.08.018
基金项目:
中文摘要:

目的: 探讨肱骨远端解剖型锁定接骨板(distal humeral plate,DHP)治疗老年骨质疏松性肱骨远端骨折的方法与疗效.

方法: 2008年9月至2010年1月,手术治疗18例老年骨质疏松性肱骨远端骨折,男3例,女15例;年龄62~83岁,平均71.4岁.骨折按照AO分型:A2型1例,A3型3例,B1型2例,B2型2例,C1型3例,C2型4例,C3型3例.经肱三头肌两侧入路或尺骨鹰嘴"V"形截骨入路,均采用切开复位DHP内固定,术后早期积极进行功能锻炼.按照Mayo肘关节功能评分(MEPS)评估疗效.

结果: 所有患者术后获得随访,时间11~24个月,平均14.6个月.骨折均获愈合,无感染、内固定失效或骨折再移位.肘关节平均屈伸78°(10°~131°),屈曲113°(65°~134°),伸直25°(0~75°).MEPS评分平均(92.2±9.6)分(65~100分),其中疼痛(42.5±5.8)分(30~45分),关节活动范围(19.2±1.9)分(15~20分),稳定性(9.2±1.9)分(5~10分),日常功能(21.4±2.9)分(15~25分).本组患者优11例,良5例,可2例.

结论: 应用DHP治疗老年骨质疏松性肱骨远端骨折能获得坚强固定,有利于早期肘关节功能锻炼从而获得良好治疗效果.
【关键词】肱骨骨折  肘关节  骨折固定术,内
 
Internal fixation with AO distal humerus plates for the treatment of distal humeral fractures in elderly osteoporotic patients
ABSTRACT  

Objective: To study the clinical effects of AO distal humerus plate(DHP) for the treatment of distal humeral fractures in elderly osteoporotic patients.

Methods: From September 2008 to January 2010,18 elderly osteoporotic patients with distal humeral fractures were treated with open reduction and internal fixation with DHP. There were 3 males and 15 females,ranging in age from 62 to 83 years(averaged,71.4 years). According to AO classification,1 patient was Type A2,3 patients were Type A3; 2 patients were Type B1,2 patients were Type B2;3 patients were Type C1,4 patients were Type C2,3 patients were Type C3. The surgical approaches were either bilateral or via olecranon process of ulna. Early mobilization was initiated after surgery. Functional results were evaluated according to the Mayo elbow performance score(MEPS).

Results: The average duration of follow-up was 14.6 months(ranged from 11 to 24 months). All the patients had a complete healing of their fractures. There was no infection,hardware failure or loss of reduction after the operations. The average Mayo elbow performance score(MEPS) was(92.2±9.6)(65 to 100 points),among which the score of pain was (42.5±5.8)(30 to 45 points),the score of motion range was(19.2±1.9)(15 to 20 points),the score of stability was(9.2±1.9 )(5 to 10 points),and the score of function was(21.4±2.9)(15 to 25 points). According to MEPS,11 patients got excellent results,5 good and 2 fair.

Conclusion: Treatment of distal humeral fractures in elderly osteoporotic patients with AO distal humeral plates can obtain immediate stabilization which facilitates early mobilization of the elbow.
KEY WORDS  Humeral fractures  Elbow joint  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:季滢瑶,郑立程,黄忠胜,李科伦,赵政,郑钜晗,陈志豪,倪建光.解剖型锁定接骨板治疗老年骨质疏松性肱骨远端骨折的初步疗效观察[J].中国骨伤,2011,24(8):681~683
英文格式:JI Ying-yao,ZHENG Li-cheng,HUANG Zhong-sheng,LI Ke-lun,ZHAO Zheng,ZHENG Ju-han,CHEN Zhi-hao,NI Jian-guang.Internal fixation with AO distal humerus plates for the treatment of distal humeral fractures in elderly osteoporotic patients[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(8):681~683
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