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OBJECTIVE@#To investigate the risk factors of elbow stiffness after open reduction and internal fixation of intercondylar fracture of humerus.@*METHODS@#From March 2015 to February 2019, 120 patients with humeral intercondylar fractures were treated with open fixation including 59 males and 61 females, aged from 25 to 77 years with an average of(53.5±3.2) years. According to the occurrence of elbow stiffness after operation, 120 patients were divided into stiffness group(37 cases) and control group(83 cases). The related factors of elbow stiffness were analyzed by single factor analysis, and the risk of elbow stiffness after internal fixation of humeral intercondylar fracture was analyzed by logistic regression factor.@*RESULTS@#There were 37 cases of elbow stiffness(stiff group), and 83 cases had no elbow stiffness(control group). The incidence of joint stiffness was 30.83%. There were significant differences between the stiffness group and the control group in age, injury energy, fracture to operation time, AO classification of fracture, open injury and postoperative premature or hyperactivity. Multivariate logistic regression analysis showed that age>50 years old, high energy injury, AO classification of fracture, open fracture and postoperative premature or hyperactivity were risk factors for elbow stiffness after internal fixation of humeral intercondylar fracture. The postoperative mobility and Mayo elbow performance score(MEPS) scores of the postoperative stiffness group were lower than those of the non-stiffness group with statistical significance(P<0.05). There were no significant differences in postoperative mobility and MEPS scores between flexion stiffness and rotation stiffness after humeral intercondylar fracture(P>0.05).@*CONCLUSION@#In view of the risk factors of elbow stiffness after internal fixation of humeral intercondylar fracture, reasonable operation plan and rehabilitation strategy should be formulated before operation to minimize the incidence of elbow stiffness.
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Objective To evaluate the effect of olecranon osteotomy and triceps pedicel approach combined with ossylated triol in the treatment of humeral intercondylar fracture and its effect on prognosis. Methods Ninety-two patients with humeral intercondylar fractures were selected as study subjects. The patients were randomly divided into two groups: the study group and the control group. The study group selected the olecranon osteotomy for treatment. The control group selected brachial Triceps tongue tongue approach for treatment. Results The excellent and good rate of the study group was significantly higher than that of the control group (P<0.05). The mean time of operation and the time of fracture healing were significantly higher than those of the control group (P<0.05), and The data of PLT, ESR, CRP and RF in the two groups were significantly lower than those in the control group (P<0.05) , and the data of inflammatory indexes in the study group were significantly decreased (P<0.05).Conclusion The treatment of humeral intercondylar fractures with olecranon osteotomy combined with calcitriol has a direct effect. It can be seen that this treatment has a high value in clinical orthopedic treatment.
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[Objective]To study the effects of AO double plates in internal fixation of humeral intercondylar fractures and to analyze the causes of the disfunction in elbow.[Method]From March 2001 to March 2006,21 cases (male 14, female 7) of humeral intercondylar fractures were reviewed, with an average age of 35.3 years (ranged,15～64 years).Left elbow:9 cases;right elbow:12 cases.According to AO/ASIF classification,type C1∶6,type C2∶10, and type C3∶5,2 cases of all were open fractures. Posterior operating approach of elbow: trans-olecranon osteotomy or trans-triceps-side approach and internal fixation by standard method of AO double plates were performed in all cases.The patients began the active training of elbow joint as soon as possible postoperatively.[Result]Twenty-one cases were followed up for 8～38 months and the average time was 14.8 months.Bone union was obtained in all cases.One case complicated wound infection,it recovered after 3 weeks of dressing.And 1 case complicated with radial nerve injury,which recovered with neural nutrients.According to the Cassebaum scoring system,the effects were evaluated as excellent 7,good 10,and fair 4,and the excellent-good rate was 80.9%.[Conclusion]The application of AO double plates was proved to be a good method to treat humeral intercondylar fractures at present. But the severity of the bone comminution and soft-tissue lesion, the effective fixation,earlier active exercise were the main causes that influence the functional recovery of elbow joint.