【摘要】：[目的]探討ILizarov骨外固定技術(shù)聯(lián)合內(nèi)固定治療肘關(guān)節(jié)周圍骨折對臨床療效的影響。[方法]回顧性分析2009年5月~2014年12月本院收治的肘關(guān)節(jié)周圍骨折患者臨床資料,獲得完整隨訪39例,納入研究。18例采用Ilizarov骨外固定技術(shù)結(jié)合切開復(fù)位內(nèi)固定手術(shù)方式,為聯(lián)合固定組;男10例,女8例;平均年齡36.2歲(21~58歲)。21例采用切開復(fù)位內(nèi)固定手術(shù),為內(nèi)固定組,男14例,女7例;平均年齡35.3歲(18~66歲)。術(shù)后門診隨訪指導(dǎo)患者功能鍛煉、觀察骨折愈合情況,術(shù)后12個月對肘關(guān)節(jié)功能行Mayo評分,并記錄肘關(guān)節(jié)屈伸活動度(ROM)。對兩組患者術(shù)后肘關(guān)節(jié)功能進(jìn)行對比評價。[結(jié)果]聯(lián)合固定組與內(nèi)固定組患者平均愈合時間分別為8.6、8.3周。Mayo評分:外固定聯(lián)合組為(88.8±8.9)分,優(yōu)良率88.9%;內(nèi)固定組為(76.5±11.8)分,優(yōu)良率為66.7%。肘關(guān)節(jié)平均活動度(ROM):聯(lián)合固定組為(116.2±10.5)°;內(nèi)固定組為(85.6±13.6)°。兩組對比聯(lián)合固定組肘關(guān)節(jié)功能明顯好于內(nèi)固定組(P0.05)。[結(jié)論]Ilizarov骨外固定技術(shù)聯(lián)合內(nèi)固定治療肘關(guān)節(jié)周圍骨折,能增加肘關(guān)節(jié)骨折內(nèi)固定穩(wěn)定性,并允許患者術(shù)后早期在鉸鏈控制下進(jìn)行功能鍛煉,與單純內(nèi)固定相比,能有效預(yù)防關(guān)節(jié)僵硬、軟組織攣縮等并發(fā)癥的發(fā)生,使肘關(guān)節(jié)周圍骨折術(shù)后獲得滿意的臨床療效。
[Abstract]:[objective] to investigate the effect of ILizarov external fixation combined with internal fixation on the treatment of elbow periarticular fractures. [methods] from May 2009 to December 2014, the clinical data of 39 patients with perielbow fracture were retrospectively analyzed and included in the study. 18 patients were treated with Ilizarov external fixation combined with open reduction and internal fixation. Combined fixation group; There were 10 males and 8 females, the mean age was 36.2 years (21 / 58 years), 21 cases were treated with open reduction and internal fixation, 14 cases were male and 7 cases were female, the mean age was 35.3 years (18 / 66 years). Postoperative outpatient follow-up guided patients with functional exercise, observed fracture healing, performed Mayo scores on elbow function 12 months after operation, and recorded elbow flexion and extension activity (ROM). The function of elbow joint after operation in two groups was compared and evaluated. [results] the average healing time of patients in the combined fixation group and the internal fixation group was 8.6 and 8.3 weeks respectively. Mayo score: (88.8 鹵8.9) points in the combined external fixation group, and the excellent and good rate was 88.9%; In the internal fixation group, the score was (76.5 鹵11.8) and the excellent and good rate was 66.7%. The mean mobility of elbow joint was (116.2 鹵10.5) 擄in (ROM): combined fixation group and (85.6 鹵13.6) 擄in internal fixation group. The elbow joint function of the combined fixation group was significantly better than that of the internal fixation group (P0.05). [conclusion] Ilizarov external fixation combined with internal fixation can increase the stability of elbow fracture internal fixation, and allow patients to exercise under hinge control early after operation, compared with simple internal fixation. It can effectively prevent the occurrence of complications such as joint stiffness, soft tissue contracture and so on, so that satisfactory clinical curative effect can be obtained after operation of elbow periarticular fracture.
【作者單位】： 濱州醫(yī)學(xué)院附屬醫(yī)院創(chuàng)傷骨科;
【分類號】：R687.3

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