摘要目的 探讨后正中入路干骺端锁定加压钢板(metaphyseal locking compression plate,MLCP)治疗肱骨干下段骨折的可行性.方法 自2005年1月至2014年1月,我科共收治63例肱骨干下段骨折患者,其中治疗组采用后正中入路MLCP固定35例,对照组采用前外侧入路锁定加压钢板(locking compression plate,LCP)固定28例.记录两组的手术时间、术中出血量、骨折愈合时间及并发症.采用Mayo评分评价两组术后肘关节功能.结果 术后所有患者均获得随访,时间为10～ 24个月,平均16.3个月.治疗组平均手术时间为(64.60±5.07) min,骨折平均愈合时间为(8.94±2.10)周,并发症发生率为2.9％;而对照组平均手术时间为(83.36± 13.42) min,骨折平均愈合时间为(12.46±2.27)周,并发症发生率为25.0％.治疗组在手术时间、骨折愈合时间、并发症发生率方面均优于对照组,差异有统计学意义(P＜0.05).而两组在术中出血量及Mayo评分方面差异无统计学意义(P＞0.05).结论 后正中入路MLCP治疗肱骨干下段骨折,具有手术时间短、骨折愈合时间短、并发症少等优点,是治疗肱骨干下段骨折的有效方法.

abstractsObjective To investigate the feasibility of treating distal humeral shaft fractures with metaphyseal locking compression plate (MLCP)fixation through the posterior midline approach.Methods Sixty-three patients with distal humeral shaft fractures who were admitted to our hospital from January 2005 to January 2014 were divided into two groups.Patients in the treatment group (n =35) underwent metaphyseal locking compression plate (MLCP) fixation through the posterior midline approach,while those in the control group (n =28) had locking compression plate (LCP) fixation through the anterior lateral approach.Operation time,intraoperative blood loss,fracture healing time and complications were recorded for both groups.Mayo elbow scores were used for evaluation of the postoperative elbow function of each group.Results All the 63 patients were follow-up for 10 to 24 months,with a mean of 16.3 months.The mean operation time,mean fracture healing time and complication rate were (64.60± 5.07)minutes,(8.94 ± 2.10) weeks and 2.9％ in the treatment group,respectively,while those in the control group were (83.36 ± 13.42) minutes,(12.46 ± 2.27) weeks and 25.0％,respectively.The treatment group did significantly better in terms of operation time,fracture healing time and complication rate (P ＜ 0.05).There was no significant difference in intraoperative blood loss and Mayo elbow scores between the two groups (P ＞ 0.05).Conclusion MLCP fixation through the posterior midline approach is an effective way to treat distal humeral shaft fractures.It has several advantages including short operation time,short fracture healing time,and fewer complications.