Objective:To compare clinical outcomes of perpendicular or parallel double plate in treating type C fractures of distal humerus in adults.Methods:From March 2009 and March 2013,40 adult patients with type C distal humerus fractures were treated.The patients were divided into two groups according to fixed form.In perpendicular group (group A),there were 13 males and 9 females with a mean age of (37.56±9.24) years old (ranged 18 to 56);while in parallel plating group (group B),including 11 males and 7 females,with a mean age of (41.35±9.03) year old(ranged 20 to 53).All fractures were fresh and closed without blood vessels or nerve damaged.Incision length,operating time,blood loss,hospital stay,preoperative and postoperative radiological change,range of activity of elbow joint,Mayo score,flexor and extensor elbow strength,and postoperative complications were observed and compared.Results:All incisions were healed well.One patient occurred myositis ossificans between two groups.Two patients in group A and 1 patient in group B occurred elbow joint stiffness.All fractures were obtained bone union.Group A were followed up from 20 to 36 months with an average of (25.2±7.1) months,while group B were followed up from 18 to 35 months with an average of(24.3±6.0) months.There were significant differences in blood loss and operative time,while there was no obvious meaning in incision length,hospital stay,muscle strength,fracture healing time,range of activity of elbow joint.Mayo score of group A was 82.27±10.43,6 cases obtained excellent results,12 good,3 moderate and 1 poor;in group B was 81.94±12.02,5 cases obtained excellent results,9 good,3 moderate and 1 poor;and there were no statistical significance between two groups.Conclusion:There was no significant differences in clinical effects between perpendicular and parallel double plate for adult patients with type C distal humerus fractures,while the operation should choose according to facture and proficiency of operator.%目的:比较使用垂直双钢板或平行双钢板内固定治疗C型肱骨远端骨折的临床疗效.方法:自2009年3月至2013年3月采用双钢板内固定治疗40例C型肱骨远端骨折患者,按固定方式不同分为两组:垂直双钢板固定组(A组)和平行双钢板固定组(B组).A组22例,男13例,女9例,年龄18～56岁,平均(37.56±9.24)岁;B组18例,男11例,女7例,年龄20～53岁,平均(41.35±9.03)岁;两组均为新鲜闭合性骨折,无血管及神经损伤.观察并比较两组患者的手术切口长度、手术时间、手术出血量、住院时间、影像学变化、肘关节活动范围、Mayo肘关节评分、肘关节屈伸肌肌肉力量以及并发症等情况.结果:全部病例术后切口愈合良好,两组术后各出现1例骨化性肌炎;A组2例、B组1例出现肘关节僵硬,术后骨折均获骨性愈合.A组随访20～ 36个月,平均(25.2±7.1)个月,B组随访18～ 35个月,平均(24.3±6.0)个月.两组手术出血量、手术时间比较差异有统计学意义;但手术切口、住院天数、肌肉力量、骨折愈合时间、肘关节活动范围等方面两组比较差异无统计学意义.A组Mayo肘关节评分为82.27±10.43,优6例,良12例,可3例,差1例;B组为81.94±12.02,优5例,良9例,可3例,差1例;两组比较差异无统计学意义.结论:垂直双钢板与平行双钢板对中青年C型肱骨远端骨折的临床疗效无明显差异,但具体术式的选择仍需要根据骨折的具体情况以及术者对术式的熟练程度.
展开▼
