目的 探讨经肘前入路复位内固定治疗Bryan-MorreyⅣ型肱骨小头骨折的操作要点、固定理念及治疗效果.方法 我院2013年10月至2016年7月采用肘前入路复位内固定治疗Bryan-MorreyⅣ型肱骨小头骨折患者9例,螺钉固定7例、克氏针固定2例.观察患者术后骨折复位质量、肘关节功能及并发症发生情况.结果 经过8~21个月随访,9例骨折均骨性愈合,无神经血管损伤、肱骨小头坏死等并发症.按M ayo肘关节功能评分,优良率89%.结论 经肘前入路复位应用三钉两柱理念固定治疗Bryan-MorreyⅣ肱骨小头骨折具有可视下复位、内固定物植入方向可控、固定牢固、关节功能恢复满意的优点,具有临床应用价值.%Objective To explore the operating points,fixation ideas and effect of treatment of Bryan-Mor-rey Ⅳ-type capitulum humeral fracture through anterior elbow approach and internal fixation.Methods From Oc-tober 2013 to July 2016,nine patients with Bryan-Morrey Ⅳ-type capitulum humeral fracture were admitted into our hospital,and they are treated through anterior elbow approach and internal fixation,of which seven patients were treated through internal screw fixation,and two through Kirschner pins fixation.Then the quality of fracture reduction,the function of elbow joint and the occurrence of complication were observed.Results After 8-21 months follow-up,it is found that 9 cases of fractures achieved bony union,without nerve vascular injury,capitu-lum humeral necrosis and other complications.According to Mayo Elbow-Performance Score,the excellent and good rate was 89%.Conclusion Some advantages such as visual reduction,controllable implantation direction of internal fixation,firm fixation and satisfying joint function recovery are existed in the treatment of Bryan-MorreyⅣ-type capitellum fracture through anterior elbow approach and internal fixation,which is of clinical application value.
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