标题：切开复位内固定治疗成人肱骨小头骨折伴或不伴后髁骨折效果比较

      作者：蒲博强，黄友华，杨 能，符林雄
    (海口市人民医院骨科中心，海南 海口 570208)

      卷次： 2015年26卷9期

      【摘要】 目的 观察切开复位内固定在成人肱骨小头骨折伴或不伴后髁骨折患者中的应用价值。方法 回顾
性分析 2010年 1月 1日至 2013年 6月 1日收治的 50例肱骨小头骨折伴或不伴后髁骨折患者的临床资料，患者
均行切开复位内固定治疗，观察患者肘关节伸屈活动度、前臂旋转活动度和肘关节外翻稳定性情况，分析患者术
后Mayo肘关节功能评分系统(MEPS)评分。结果 患者患侧肘关节的伸直活动度均小于健侧对应活动度，患侧
屈曲活动度和屈伸活动度大于健侧(P<0.05)，但患者患侧肘关节的前臂旋转活动度与健侧前臂旋转活动度比较
差异无统计学意义(P>0.05)。肱骨小头骨折伴后髁骨折患者的平均屈伸度小于不伴后髁骨折患者(P<0.05)，且肱
骨小头骨折伴后髁骨折患者的MEPS评分也明显低于不伴后髁骨折患者(P<0.05)。结论 切开复位内固定可有
效改善成人肱骨小头骨折患者肘关节活动度，患者若伴有后髁骨折则需加强治疗，巩固治疗效果。

      【关键词】 肘关节；骨折固定术；活动度

      【中图分类号】 R683.41 【文献标识码】 A 【文章编号】 1003—6350（2015）09—1279—03


Effect of open reduction and internal fixation in the treatment of fracture of the capitellum complicated with or
without posterior condylar fracture in adults.
PU Bo-qiang, HUANG You-hua, YANG Neng, FU Lin-xiong.
Department of Orthopaedics, Haikou People's Hospital, Haikou 570208, Hainan, CHINA

【Abstract】 Objective To evaluate the effect of open reduction and internal fixation for fracture of the capi-
tellum complicated with or without posterior condylar fracture in adults. Methods The clinical data of 50 adult pa-
tients with facture of capitellum complicated with or without posterior condylar fracture admitted in our hospital from
January 1, 2010 to June 1, 2013 were retrospectively analyzed. All patients were treated by open reduction and internal
fixation. Range of extension and flexion of elbow joint, forearm rotation, elbow joint valgus stability of all patients
and MEPS score were statistically analyzed. Results Range of extension of ipsilateral elbow of patients were smaller
than that of contralateral elbow, but range of flexion, range of extension and flexion of ipsilateral elbow were bigger
than those of contralateral elbow (P<0.05). Forearm rotation of both sides patients had no statistically significant dif-
ferences (P>0.05). The average range of extension and flexion of patients with capitellum complicated with posterior
condylar fracture were smaller than that of patients with capitellum not complicated with posterior condylar fracture
(P<0.05). And MEPS score of patients with capitellum complicated with posterior condylar fracture were lower than
that of patients with capitellum not complicated with posterior condylar fracture (P<0.05). Conclusion Open reduc-
tion and internal fixation for fracture of capitellum in adults can improve elbow motion, and the patients complicated
with posterior condylar fracture should receive strengthened and consolidated treatment.

      【Key words】 Elbow; Fracture fixation; Activity