| 切开复位内固定治疗GustiloⅠ-Ⅱ型肱骨远端开放骨折 |
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Received:December 19, 2018
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陈辰 |
CHEN Chen |
北京积水潭医院创伤骨科, 北京 100035 |
Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China |
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| 查晔军 |
ZHA Ye jun |
北京积水潭医院创伤骨科, 北京 100035 |
Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China |
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| 李庭 |
LI Ting |
北京积水潭医院创伤骨科, 北京 100035 |
Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China |
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| 蒋协远 |
JIANG Xie yuan |
北京积水潭医院创伤骨科, 北京 100035 |
Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China |
jxy0845@sina.com |
| 赖良鹏 |
LAI Liang peng |
北京积水潭医院创伤骨科, 北京 100035 |
Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China |
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| 公茂琪 |
GONG Mao qi |
北京积水潭医院创伤骨科, 北京 100035 |
Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China |
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| 期刊信息：《中国骨伤》2019年32卷，第4期，第350-354页 |
| DOI：10.3969/j.issn.1003-0034.2019.04.011 |
| 基金项目:北京市卫生和计划生育委员会北京市卫生与健康科技成果和适宜技术推广项目（编号：2018-TG-23）；北京积水潭医院学科新星（编号：JST201704）；2015年度北京市医院管理局人才培养"登峰"计划（编号：DFL20150401） |
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目的：探讨切开复位内固定治疗GustiloⅠ-Ⅱ型肱骨远端骨折的临床疗效。
方法：自2013年5月至2017年6月采用切开复位内固定治疗24例GustiloⅠ-Ⅱ型肱骨远端开放骨折患者，其中男20例，女4例；年龄14~65（41.3±13.1）岁；根据Gustilo分型，Ⅰ型16例，Ⅱ型8例。记录患肘的活动范围、术后并发症及二次手术的情况，并于术后12个月时采用主观疼痛视觉模拟评分（visual analogue scale，VAS），Mayo肘关节功能评分（Mayo elbow performance score，MEPS）及快速肩臂手功能障碍评分量表（quick disabilities of the arm，shoulder and hand，QuickDASH）评价患肘功能恢复情况。
结果：所有患者获得随访，时间15~60（34.1±11.9）个月。术后12个月VAS评分为0（0，2）分。术后患肘屈伸活动度为50°~145°（115.2±26.1）°，旋转100°~160°（147.7±17.0）°。MEPS评分为90.0±9.1，优14例，良10例。QuickDASH评分为4.6（0，14.8）分。并发症发生22例，包括尺神经症状、内固定激惹等，二次手术患者10例。
结论：切开复位内固定是一种治疗Gustilo Ⅰ-Ⅱ型肱骨远端开放骨折安全有效的方法，患者活动范围好，功能评分满意。 |
| [关键词]:肱骨骨折 骨折固定术，内 骨折切开复位 |
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| Clinical outcomes of open reduction and internal fixation in treating Gustilo typeⅠandⅡpatients with open distal humeral fractures |
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Abstract:
Objective:To analysis clinical effects of open reduction and internal fixation in treating Gustilo typeⅠandⅡ patients with open distal humeral fracture.
Methods:From 2013 May to 2017 June,24 patient with Gustilo gradeⅠandⅡopen distal humeral fractures were treated with open reduction and internal fixation,including 20 males and 4 females,aged from 14 to 65 years old with an average of (41.3±13.1) years old. According to Gustilo classification,16 patients were typeⅠ,8 patients were typeⅡ. Range of motion,complications and secondary surgery were recorded;elbow function were evaluated with VAS (visual analogue scale),MEPS (Mayo elbow performance score) and QuickDASH (quick disabilities of the arm,shoulder,and hand) at 12 months after operation.
Results:All patients were followed up from 15 to 60 years with an average of (34.1±11.9) months. VAS score was 0(0,2);flexion and extension ranged from 50 °to 145° with an average of (115.2±26.1)°;the range of rotation ranged from 100° to 160° with an average of (147.7±17.0)°. MEPS score was for 75 to 90 (90.0±9.1),and 14 patients got excellent result,10 patients moderate. Quick DASH score was 4.6(0,14.8). There were 22 patients occurred complications,such as ulnar nerve symptom and internal fixation irritation,and 10 patients accepted the second operation.
Conclusion:Open reduction and internal fixation is a safe and efficient method in treating Gustilo typeⅠandⅡpatients with open distal humeral fractures,which has an advantages of good range of movement and function score. |
| KEYWORDS:Humeral fractures Fracture fixation,internal Open fracture reduction |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈辰,查晔军,李庭,蒋协远,赖良鹏,公茂琪.切开复位内固定治疗GustiloⅠ-Ⅱ型肱骨远端开放骨折[J].中国骨伤,2019,32(4):350~354 |
| 英文格式: | CHEN Chen,ZHA Ye jun,LI Ting,JIANG Xie yuan,LAI Liang peng,GONG Mao qi.Clinical outcomes of open reduction and internal fixation in treating Gustilo typeⅠandⅡpatients with open distal humeral fractures[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(4):350~354 |
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