摘要
一、目的：通过对近5年我院肱骨髁间骨折的病例资料进行分析研究，总结出这种临床上相对少见、治疗困难的肱骨髁间骨折的治疗经验，为该骨折合理的手术入路、固定方法方面提供指导。
二、方法：回顾性随访调查近5年我院在临床中采用手术治疗肱骨髁间骨折的46例病人。对其临床资料包括：手术入路、手术操作时间、出血量、内固定方式、肘关节的功能结果、并发症等有关数据进行收集、整理、总结、分析及研究。
三、结果：在46例中，31例采用尺骨鹰嘴截骨入路，15例采用肱三头肌舌形瓣入路。单纯克氏针固定4例，骨片钉内固定2例，Y型钢板内固定2例，单钢板螺丝钉内固定8例，双钢板内固定17例，双张力带内固定13例。随访37例，按Morrey标准，优28例，良6例，差3例。在具有代表性的双钢板(DP)及双张力带固定(DTB)两组病例中，手术时间及出血量双张力带组均少于双钢板组(P＜0.05)。在临床结果上双张力带及双钢板组均获得相同的效果(P＞0.05)。
四、结论：尺骨鹰嘴截骨入路是肱骨髁间骨折常用及效果满意的入路，双钢板及双张力带内固定为目前治疗该骨折主要的固定方式，双钢板内固定具有坚强、可靠的特点。而双
天津医科大学硕士研究生论文
张力带内固定临床应用中具有操作简单特点，也是一种可
以推广使用的方法。
Objective: By analysis the data on the distal humerul fractures managed in our hospital in recent five years. To summarize the experience of treatment on the fractures which is uncommon and difficult to treat, to provide the treatment principle of approach and fixation on this fractures. Method: We retrospective reviewed 46 patients with intra-articulr fractures of the distal humerus in the past 5 years. The whole clinical data were obtained, including approach, operating time, blood losing, types of internal fixation, function of the elbow, and complains and so on. To collect the data and then to analyse. Result: Of the 46 patients, olecranon osteotomy 31 cases, triceps flap 15 cases, the osteosynthesis with simple K-wire 4 cases, thread K-wire 2 cases, "Y" plate 2 cases, single plate 8 cases, dual-plate (DP) 17 cases, with double tension band(DTB) 13 cases. We fellow up 37 cases, according to Morrey' s evaluation standard: excellent 28 case, good 6 cases, fair 3 cases, double tension band with less time and blooding in comparison with dual-plates,
however, osteosynthesis with dual-plate or with double tension band can provide satisfied results. Conclusion: Olecranon osteotomy is a common and effective form of surgical exposure for treatment of the intra-articular fractures of distal humerus . The main method for this fractures is osteosynthesis with dual-plate (DP) or with double tension band(DTB), fixed with dual-plate (DP) is rigid as well as reliable, while double tension band(DTB) characterized with easy to operate, and is a good way to manage the intra-articular fractures of distal humerus.
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