Treatment of AO Type C Fractures of the Distal Part of the Humerus through the Bryan-Morrey Triceps-Sparing Approach.
Treatment of AO Type C Fractures of the Distal Part of the Humerus through the Bryan-Morrey Triceps-Sparing Approach.
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DOI：
10.1155/2013/525326
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Prat S
中科院分区：
文献类型：
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作者：
Fernández-Valencia JA;Muñoz-Mahamud E;Ballesteros JR;Prat S
为了避免鹰嘴截骨术治疗肱骨远端关节骨折的并发症，已经介绍了几种替代方法。关于保留肱三头肌方法的已发表的经验很少。在这项前瞻性研究中，共有12例肱骨关节骨折患者采用该入路治疗。在平均1.7年的随访中，平均活动范围为112.8°（范围从85°到135°）；肘关节屈曲平均为125.5°（范围为112°至135°），肘关节伸直不足14.6°（范围为0°至30°）。所有的肘部都很稳定。梅奥肘部表现评分（MEPS）平均为93.3（范围从80到100）。在本系列中，没有发现肱三头肌与鹰嘴再附着失败，所有患者都能恢复到以前的日常生活活动，没有损伤，MEPS令人满意。综上所述，保留肱三头肌入路可以考虑治疗肱骨远端关节骨折。我们认为有三种临床情况更适合使用这种入路：可能需要全肘关节假体的病例，同侧骨干骨折的病例，或鹰嘴内存在先前的固定物的病例。
Several alternative approaches have been described to avoid the complications related to the olecranon osteotomy used to treat distal articular humerus fractures. The published experience with the triceps-sparing approach is scant. In this prospective study, a total of 12 patients with an articular humeral fracture were treated using this approach. At a mean followup of 1,7 years, the average range of motion was 112.8° (range from 85° to 135°); the elbow flexion averaged 125.5° (range from 112° to 135°) and the deficit of elbow extension 14.6° (range from 0° to 30°). All the elbows were stable. The Mayo Elbow Performance Score (MEPS) averaged 93.3 (range from 80 to 100). In the present series no failure of the triceps reattachment to the olecranon was found, and all the patients recalled returning to their previous daily life activities without impairment with a satisfactory MEPS. As a conclusion, the triceps-sparing approach can be considered for treating distal articular humerus fractures. We consider that three clinical settings can be more favorable to use this approach: those cases in which a total elbow prosthesis might be needed, cases of ipsilateral diaphyseal fracture, or presence of previous hardware in the olecranon.