Dubberley B型肱骨小头骨折开放复位联合内固定△

Open reduction and combined internal fixations for Dubberley type B capitellum fractures

摘要:

[目的]探讨微型钢板联合埋头钉、克氏针固定 Dubberley B 型肱骨小头骨折的临床疗效。[方法]回顾性分析 2016 年 3 月—2019 年 8 月本院收治的 13 例 DubberleyB 型肱骨小头骨折患者的临床资料。选择肘关节外侧入路并采用微型钢板联合埋头钉及克氏针固定。[结果]手术均完成顺利，无严重医源性损伤发生。平均随访时间(17.5±2.7)个月。恢复患肢完全持重活动时间为 (15.3±1.6) 周。随时间的推移，13 例患者 VAS 评分显著下降 (P＜0.05)，肘伸屈 ROM 和 MEPS 评分显著提升 (P＜0.05)。术后影像显示，12 例解剖复位；1 例骨折移位＜2 mm，不伴成角或旋转移位。末次随访所有患者均达骨折愈合，无骨块移位，2 例轻度骨性关节炎，1 例异位骨化并发症。[结论] 采用锁定钢板联合埋头钉及克氏针联合固定可有效治疗 Dub- berleyB 型肱骨小头骨折。

Abstract:

[Objective] To investigate the clinical outcomes of mini plate combined with countersunk screws and Kirschner wire for Dubberley type B capitellum fractures. [Methods] A retrospective study was done on 13 patients who received surgical treatment for Dub- berley type B capitellum fractures in our hospital from March 2016 to August 2019. All patients underwent open reduction and internal fixa- tion with mini plate combined countersunk screws and Kirshner wires through lateral approach. The clinical and imaging consequences were observed. [Results] All the patients had operation completed successfully without serious iatrogenic injuries, and followed up for (17.5±2.7) months on an average with time to resume full weight activity of the affected limb of (15.3±1.6) weeks. The VAS score decreased significantly (P＜0.05), whereas elbow extension-flexion ROM and MEPS scores significantly increased in all the 13 patients (P＜0.05). Post- operative images showed anatomical reduction in 12 cases, and displacement less than 2 mm without angulation or rotation in one case. At latest follow-up, all patients achieved fracture healing without further displacement of bone fragment, whereas 2 patients had mild osteoar- thritis, and one patient had heterotopic ossification. [Conclusion] Mini plate combined with countersunk screw and Kirschner wires does ef- fectively fix Dubberley type B humeral capitellum fracture.