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find Keyword "肱骨远端" 18 results
  • 复杂肱骨远端骨折的双钢板内固定治疗

    【摘要】 目的 总结双钢板内固定治疗复杂肱骨远端骨折的临床疗效。 方法 2004年1月-2008年5月,采用双钢板内固定治疗15例复杂肱骨远端骨折患者。按照AO/ASIF分型,患者均为C型骨折。其中C1型4例,C2型4例, C3型7例。受伤至手术时间平均2.5 d。C1、C2型骨折复位后用双钢板固定,C3型骨折复位后先用细克氏针固定髁间骨折块,再用双钢板固定。手术后3~5 d佩带活动型肘关节支具进行功能锻炼。随访观察7~16个月,平均13个月。按照Mayo评分标准评定肘关节功能。 结果 15例患者肱骨髁间及髁上骨折均愈合,时间为3~6个月,平均4.5个月。Mayo评分:优8例,良4例,可2例, 差1例,优良率80%。 结论 对复杂肱骨远端骨折采取早期切开解剖复位、双钢板内固定,使用活动型肘关节支具进行早期功能锻炼,能显著降低相关并发症,促进肘关节功能的恢复。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • 经尺骨鹰嘴截骨双侧锁定加压钢板内固定治疗C型肱骨远端骨折

    目的总结经尺骨鹰嘴截骨双侧锁定加压钢板治疗C型肱骨远端骨折的疗效。 方法2008年9月-2013年5月,采用经尺骨鹰嘴截骨双侧锁定加压钢板固定治疗21例C型肱骨远端骨折患者。其中男12例,女9例;年龄18~64岁,平均38岁。致伤原因:跌伤7例,交通事故伤14例。均为新鲜闭合骨折。根据国际内固定研究协会(AO/ASIF)分型:C1型9例,C2型6例,C3型6例。受伤至手术时间5~11 d,平均7 d。 结果术后切口均Ⅰ期愈合,无感染及神经损伤发生。21例均获随访,随访时间7~24个月,平均16个月。2例于术后6个月发生异位骨化,术后1 年行异位骨化切除,功能无明显改善。患者骨折均愈合,愈合时间6~10个月,平均7.8个月。随访期间内固定物无松动、断裂及失效发生。术后6个月肘关节活动范围为60~136°,平均110°。术后6个月根据Mayo肘关节功能评分,获65~95分,平均87分;其中优16例,良1例,中4例,优良率为81%。 结论双侧锁定加压钢板治疗C型肱骨远端骨折固定牢固,利于术后早期行肘关节功能锻炼。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • EFFECTIVENESS OF MEDIAL-LATERAL DOUBLE PLATE INTERNAL FIXATION IN TREATING TYPE C DISTAL HUMERAL FRACTURES

    Objective To evaluate the effectiveness of open reduction and medial-lateral double plate internal fixation for type C distal humeral fractures. Methods Between June 2002 and January 2009, 32 patients with distal humeral intra-articular fractures were treated. There were 19 males and 13 females, aged 19-70 years (mean, 43.3 years). The fracture was caused by fall ing in 7 cases, by traffic accident in 15 cases, by fall ing from height in 5 cases, by crush injury in 4 cases, and by machine injury in 1 case. The time from injury to operation was 8 hours-7 days (mean, 3.3 days). Of 32 patients, 1 had open fracture and 31 had closed fracture; 5 patients compl icated by injury of ular nerve. According to AO/Association for the Study of Internal Fixation (AO/ASIF) classification, there were 9 cases of type C1, 16 of type C2, and 7 of type C3. Open reduction and medial-lateral double plate internal fixation were performed through posterior midl ine approach in 8 cases and through medial-lateral two-incision approaches in 24 cases. Results All incisions healed by first intention. The 32 cases were followed up 11-24 months (mean, 14 months). The X-ray films showed that all fractures healed at 3-6 months (mean, 3.8 months). According to Aitken et al. scoring system, the results were excellent in 22 cases, good in 6 cases, fair in 3 cases, and poor in 1 case with an excellent and good rate of 87.5%. In 5 patients with injury of ular nerve, 4 cases completely recovered at 6 months and 1 case still showed some symptoms after 1 year. Conclusion Treatment of type C distal humeral fractures with open reduction and medial-lateral double plate internal fixation can get good cl inical results.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • TREATMENT OF DISTAL HUMERUS FRACTURE WITH DOUBLE-PLATING FIXATION

    To investigate the method and cl inical effect of double-plating fixation in treatment of distal humerus fractures. Methods From April 2003 to January 2009, 21 patients with distal humerus fracture were treated with l imited contact compression plate and reconstruction plate via posterior elbow incision and approach inside and outside the edge of both sides of the triceps. There were 12 males and 9 females, aged from 20 to 63 years (39 years on average). The causes of injury were fall ing in 13 cases, traffic accident in 6 cases, and fall ing from height in 2 cases. According to the classification of Association for the Study of Internal Fixation (AO/ASIF), 8 cases were classified as type 12-B1, 2 as type 12-B2, 7 as type12-B3, 3 as type 13-A2, and 1 as type 13-A3. The course of disease averaged 4.8 days. Results Secretion was observed at incision in 1 case 2 weeks after operation, and incision healed after dressing change; other incisions healed by first intention. Transient numbness of ring and l ittle fingers occurred in 2 cases 2 days after operation; no iatrogenic nerve paralysis occurred. All patients were followed up 13 to 18 months (15 months on average). The X-ray films showed bone healed 6 months after operation. No postoperative joint adhesion occurred, and the motion of elbow joint ranged from 0° to 135°. According to Morrey evaluation standard, the results were excellent in 17 cases, good in 2 cases, and fair in 2 case; the excellent and good rate was 90.5%. Conclusion Double-plating fixation has the advantages of wide indications, rigid internal fixation, and significant curative effects in treatment of distal humerus fractures.

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • EFFECTIVENESS OF AO ANATOMICAL LOCKING COMPRESSION PLATE IN TREATING TYPE C DISTAL HUMERAL FRACTURE

    Objective To evaluate the effectiveness of the AO anatomical locking compression plate in treating type C distal humeral fracture. Methods Between July 2008 and April 2009, 13 cases of type C distal humeral fracture were treated with the AO anatomical locking compression plates. There were 5 males and 8 females with an average age of 52.1 years (range, 24-80 years). Fractures were caused by tumbl ing in 7 cases, by traffic accident in 4 cases, and by fall ing from height in2 cases. According to Association for Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification, there were 3 cases of type C1, 6 cases of type C2, and 4 cases of type C3. Two cases compl icated by ulnar nerve injuries, 1 by radial nerve injury, 2 by fractures of ulnar olecranon, 3 by fractures of other parts of extremities, and 6 by osteoporosis. The time from injury to hospital ization ranged from 3 hours to 4 days (0.9 day on average). Results All the incisions achieved heal ing by first intention. Thirteen cases were followed up 12 to 21 months with an average of 15.9 months. According to the X-ray films, unions were achieved both at fracture site and the olecranon osteotomy site with a heal ing time of 8 to 13 weeks (10 weeks on average). The function of elbows recovered from 3 to 32 weeks (10 weeks on average). No fixation failure, myositis ossifican, delayed union, or malunion occurred during the follow-up. The Mayo Elbow Performance score ranged from 75 to 100 with an average score of 95.8; the results were excellent in 9 cases, good in 3 cases, and fair in 1 case with an excellent and good rate of 92.3%. Conclusion The AO anatomical locking compression plate has a good fixation in treating type C distal humeral fracture. Through the approach of olecranon osteotomy, it is easy to get anatomical reduction, stable fixation, and early exercise.

    Release date:2016-09-01 09:04 Export PDF Favorites Scan
  • FIXATION OF DISTAL HUMERAL FRACTURE IN ELDERLY PATIENT BY LOCKING COMPRESSION PLATE

    Objective To review the outcomes of geriatric distal humeral fracture fixed with locking compression plate (LCP). Methods From January 2005 to December 2007, 24 patients (20 females and 4 males) with distal humeral fracture underwent open reduction and internal fixation with LCP. Their average age was 75.5 years old, ranged from 60 to 93 years old. Fracture was caused by injury from fall in 22 cases, by traffic accident in 1 case, and by direct hit in 1 case. There were 12 cases of type A2, 2 cases of type A3, 2 cases of type B1, 2 cases of type C1, 2 cases of type C2, 4 cases of type C3 fractures according to AO/ASIF classification. X-ray films in AP and lateral view were taken preoperatively. CT scan with three dimensional reconstructions was done in more comminuted fracture only. Open reduction with triceps sparingtechnique was used in all except type B fracture, and olecranon osteotomy was considered only in more comminuted C3fracture. The average interval between injury and operation was 3 days (range, 1-6 days). Outcome measures includedpain assessment, range of motion, and Mayo elbow performance score and findings at 1 year follow-up. Results Theaverage length of follow-up was 25 months (range, 12-48 months). All 24 fractures were healed within 6 months with anaverage of about 4 months. At 1 year follow-up, 83% (n=20) of patients felt no pain and 17% (n=4) of patients had mildpain; 83% of patient can gain a flexion range of more than 100°; according to Mayo elbow performance score, the meanscores of type A, B and C fracture groups were 97, 85, and 89, respectively, and the post-operative performance of typeA fracture was significantly better than that of type B and C (P=0.034). Four patients had postoperative compl ications.Conclusion Open reduction and internal fixation of geriatric distal humeral fracture can achieve relatively good functionalresult and bony union despite of age.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • TREATMENT OF DISTAL COMMINUTED HUMERAL FRACTURE WITH SERIOUS OSTEOPOROSIS BY TOTAL ELBOW ARTHROPLASTY

    Objective To analyse short-term cl inical effect of total elbow arthroplasty in treatment of distal comminuted humeral fracture with serious osteoporosis in geratic patients. Methods From April 2006 to October 2007, five cases of distal comminuted humeral fractures were treated by total elbow arthroplasty with bone cement. Of them, there were 2 males and 3 females, aging 50-76 years old (mean 67.6 years old), including 4 cases of closed fracture and 1 case of open fracture (II type Gustilo-Anderson). All fractures were caused by tumbl ing. According to classification of AO, there were 2 cases of type C1, 2 cases of type C2 and 1 case of type C3. The Barnett index of osteoporosis was 0.40-0.45. The time from injury to operation was 4 to 18 days (mean 7.2 days). The rehabil itation exercise of function was done after 2 days of operation. Results The operative time was from 120 to 180 minutes (mean 150 minutes), the bleeding amount was from 150 to 250 mL (mean 200 mL). All incision achieved primary heal ing. No compl ication occurred. Five cases were followed up for 19 to 36 months (mean 24.5 months). The mean motion range of elbow joint include 141.6° for flection, 6.5° for extention, 10.2° for the degree of ectropion, 81.7° for revolve forward, and 73.8° for revolve behind respectively after 4 months of operation. The length discrepancy of upper l imb was less than 1.5 cm, the muscle force for flexion and extention of finger and wrist was normal. The X-ray films showed that the position of artificial joint was satisfactory without prosthesis dislocation or loosening. According to Mayo elbow performance score, the excellent and good rate was 80% (excellent in 1 case, good in 3 cases, and fair in 1 case). Conclusion Total elbow arthroplasty with bone cement is an effective method in treatment of distal comminuted humeral fracture with serious osteoporosis obviously in the geratic patients, but indication and technique of operation should be mastered strictly.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • REPAIR OF REFRACTORY BONE NONUNION IN THE DISTAL HUMERUS

    Objective To investigate the effect of microsurgical repair of refractory bone defects and nonunion in distal humers. Methods Twelve cases of bone defects and nonunion indistal humerus wererepaired with free vascularised fibular graft and fixed with the anatomical bone plate. Of the 12 cases, 8 had pseudarthrosis, and 4 had bone defects 3-5 cm. Fibular graft ranged from 5-15 cm, 8.5 cm in average. Results After a follow-up of 3-18 months, 8.5 months in average, all cases of free vascularised fibular graft healed within 38 months. The fibular graft thickenedas time passed. Normal recessive osseous elbow joint, improvement in the inflection and extension of elbow joint, and normal revolving of antebrachium were attained. The short of limbs were corrected. Satisfactory functions of supporting and fine operation were attained. Conclusion With the support of anatomical bone plate, the fibular graft can help the recovery of joint functionand repair bone defects and nonunion as to avoid joint replacement with prosthesis.

    Release date:2016-09-01 09:27 Export PDF Favorites Scan
  • 肱骨远端骨折术后早期康复影响因素的临床护理研究

    目的分析肱骨下段骨折术后康复的影响因素,以提高患者早期康复护理效果,改善其术后远期生存质量。 方法选择符合纳入标准的于2010年3月1日-2012年1月30日入住骨科的肱骨下端骨折患者100例,采用logistic回归分析对可能影响肱骨下段骨折术后康复的影响因素进行多因素回归分析。 结果单因素分析显示不同的康复介入时间、肢体肿胀度、疼痛评分及处理、创伤后是否冰敷与肘关节功能恢复差异具有统计学意义(P<0.05)。多因素logistic回归分析,按照其作用强度,影响肘关节功能优良率的独立因素依次为:运动康复介入时间、肢体肿胀度、创伤后是否冰敷、疼痛评分及处理。 结论运动康复介入时间、肢体肿胀度及创伤后是否冰敷、疼痛评分及处理为肱骨远端骨折患者肘关节功能的独立因素。肱骨下段骨折术后康复应早期介入,及时消除肢体肿胀,给予冰敷,减轻疼痛有助于更好发挥运动康复疗效,恢复肘关节功能。

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  • 肱骨远端冠状面剪切骨折的诊疗进展

    肱骨远端冠状面剪切骨折较少见,多累及肱骨小头和滑车,且常伴有肘关节骨和软组织韧带损伤,其诊断和治疗目前尚存在诸多争议。现根据国内外文献,就肱骨远端冠状面剪切骨折的发病机制、分型、诊断、治疗进展、术后管理及并发症作一综述。

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