Limited Open Reduction And Internal Fixation Combined With External Fixator For The Treatment Of Adult Distal Humerus C-type Fractures

Abstract:Objective:To compare the curative effects of Limited open reduction and internal fixation combined with external fixator and Open reduction and internal fixation with AO two plates,to evaluate the clinical curative effects of Limited open reduction and internal fixation combined with external fixator,to find a more comprehensive and more effective way to cure Type C distal humerus fractures,to accumulate more clinical experiences.Method:1.Group A with27cases of Limited open reduction and internal fixation combined with external fixator,which includes9males and18females,among age18to75.The average age is56.6.The reason to the injury is as belows:7cases of break,10cases of falling,8cases of traffic accidents and2cases of exercise.According to the AO type standards of Muller, there’s3cases of C1,11cases of C2,13cases of C3.Select25cases of internal fixation with AO two plates randomly in the corresponding period as contrast group B,which includes8male and17female,among age18to76.The average age is57.1.The reason to the injury is as belows:5cases of break,9cases of falling,8cases of traffic accidents and3cases of exercise.According to the AO type standards of Muller, there’s4cases of C1,10cases of C2,11cases of C3.2. Observe The skin healing conditions,review bone with X-ray regularly,record the restoration and healing condition of fractures,the movement and rupture of screws,dissolve and absorb of osseous and so on.Check the range of activities of the elbow joint in the way of flexion and extension.To evaluate the elbow joints by Cassebaum,and introduce Mayo as the mainly assess to the patients.3.The curative effects of elbow joints after operation in two groups is judged by t-test and the mainly judgements of patients is X2-test.Result:All the patients after operation are review regularly12to36months.Among group A,27cases come to clinical healing of average weeks of7to11after operation and also reach Ⅰ type of wound healing.Only1case undergo fraction of screw in supracondylar humerus after clinical healing,but haven’t get fracture after removing the screws,which is all good of Cassebaum and the score of Mayo is83.1case has traumatic arthritis.1case with myositis ossificans.2cases get pains after continuously activity,but get better after taking NSAID.2cases undergo infect by needle track,but get healing after change a medical prescription.Among group B,24cases come to clinical healing of average weeks of8to12after operation and also reach Ⅰ type of wound healing.1case of type C2fracture get displacement fracture after4weeks of operation which has an significant influence in joint movement and be fixed again by operation.2cases have traumatic arthritis.1case with myositis ossificans.2cases get pains after continuously activity,but get better after taking NSAID.Conclusion:1.Compare with Open reduction and internal fixation with AO two plates, Limited open reduction and internal fixation combined with external fixator has better curative effect in some extents.2.According to type Ⅱ and Ⅲ open fractures,the first choice is Limited open reduction and internal fixation combined with external fixator.3.It’s an important way to use Traditional Chinese Medicine.no matter by expectant treatment or by operation,but should comply with cure principles of three periods. Functional exercises should be taken under the guiding of clinical doctor and follow the principle of gradual improvement.4.Limited open reduction and internal fixation combined with external fixator is easy to operate with small trauma,and can be fixed sturdy,function recovery well,which also has a good therapeutic effect and is worth of spreading and applying.