Fractures of the Distal Humerus in Adults

成人肱骨遠端骨折的治療

劉士嘉(Shyh-Jia Liou) ； 黃俊雄(Chun-Husiung Huang) ； 蘇榮源(Rong-Yuan Su) ； 賴建宏(Jiann-Horng Lai) ； 王榮彬(Jung-Pin Wang)

《Journal of Orthopaedic Surgery Taiwan》 5卷2期 (1988/06) Pp. 143-153

摘要

從民國68年到民國75年，馬階醫院共治療成人肱骨遠端骨折43例。追蹤平均37個月後，有5例失去連繫，二例死亡，結果共有36例可供追蹤結果，其中男性16例，女性20例，平均平齡52.6歲。36例中有32例接受開刀治療，4例接受保守治療。結果以功能的恢復來評估，接受開刀32例中有23例（72%）合於優等（Excellent）及佳等（Good）。32例開刀病例中有20例使用鋼釘或螺絲固定，12例使用鋼板加螺絲固定。我們認為肱骨遠端骨折以開刀治療加上內固定可得到較佳的整復，以利術後之早期復健工作。
本院概使用堪培爾後切開（Campbell's posterior approach）來整復骨折，此法可提供骨折部位良好的視野，且可將尺神經暫時拉開以避免傷害，必要時亦可同時施行尺神經前移位，如此不但可以避免日後發生遲發性尺神經麻痺，將來骨折癒合後要取出固定器時，亦可較大膽的開刀，不虞有尺神經傷害發生。

並列摘要

Thirty-six distal humeral fractures treated between 1979 and 1986 were analyzed. Thirty-two patients were treated by open reduction and internal fixation; the remainding four patients were treated by nonoperative techniques. The comparison of the results of operative and nonoperative mangement was difficult to make because the patients and their fractures were not strictly comparable and our series number was too small. Functional results were evaluated by the method of Shetty. Of the patients treated by open reduction and internal fixation, 72% had an excellent or good result. We used Campbell' posterior approach for most of our cases, this could provide good visualization and facilitate anatomic estoration. We prefer open reduction and internal fixation for the distal humeral fractures unless either they are nondisplaced fractures or there is contraindication to surgery.

並列關鍵字

Fracture ； Distal humerus ； Condylar