成人肱骨小头冠状面骨折的手术治疗Surgical treatment of coronal shear fracture of the capitellum humeri of adults
肖裕华,李绍琴,李建飞,陈宗和
摘要(Abstract):
[目的]探讨采用手术治疗成人肱骨小头冠状面骨折的固定方法和疗效。[方法]自2001年1月~2005年7月,采用手术切开直视下复位骨折,分别于肱骨小头、滑车置入螺钉固定治疗肱骨小头骨折6例。男2例,女4例,年龄27~48岁,平均38岁,左侧4例,右侧2例。所有患者均为新鲜闭合性骨折,无神经、血管损伤。手术时间为伤后3~9 d。[结果]6例手术中均无血管、神经损伤,术后伤口Ⅰ期愈合,X线片显示骨折解剖复位。全部病例均获得随访,随访时间为术后12~52个月,平均32个月。骨折临床愈合时间为6~9周,平均7周。未见肘关节骨化性肌炎、肱骨小头缺血性坏死等并发症。疗效评估在使用B roberg-Morrey评分系统标准进行评价,结果极好5例,好1例。[结论]肱骨小头冠状面骨折应行切开复位内固定术,达到解剖复位和牢固固定并早期行肘关节主动伸屈功能锻炼,疗效满意。
关键词(KeyWords): 肱骨小头;冠状面骨折;骨折固定术;肘关节
基金项目(Foundation):
作者(Author): 肖裕华,李绍琴,李建飞,陈宗和
参考文献(References):
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