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1、全肘关节置换治疗复杂肱骨課间骨折疗效分析姜保国教授北京大学人民医院［摘要］目的探讨肘关节置换术治疗复杂肱骨探间骨折的疗效。方法2005年8月〜2006年4月，通过肘关节置换术治疗了3例复杂肱骨傑间骨折患者，1例为男性，38岁，伴有血友病性关节炎，2例为女性，年龄分别为66岁、82岁，伴有类风湿性关节炎。3例肱骨探间骨折患者中的1例伴血友病关节炎和1例伴类风湿关节炎患者接受了一期肘关节置换，另一例伴类风湿关节炎的患者在行切开复位内固定手术失败后接受了肘关节置换术。3例患者均获得随访，随访吋间3〜10个月，以Mayo评分评估其肘关节功能。结果1例伴血友病关节炎的肱骨探间骨折患者术后的Mayo
2、评分为良（75分），2例伴有类风湿关节炎的肱骨躲间骨折患者屮，内固定手术失败后接受肘关节置换的患者Mayo评分为良（85分），一期肘关节置换患者的Mayo评分为优（95分），3例肘关节置换患者近期随访未出现疼痛或假体松动。结论对年龄偏大，骨质疏松明显，骨折粉碎难以复位和固定，关节毁损严重的老年肱骨碟间骨折患者，实施肘关节置换术可获得满意疗效。［关键词］肱骨探间骨折；全肘关节置换术Treatmenteffectofthecomplexhumeralintercondylarfractureswithtotalelbowreplacement.JiangBao-^uo,ZhangDian-y
3、in^,FuZhong-guo.DepartmnetofOrthopaedicsandTraumatology,PekingUniversityPeoplesHospital,Beijing100044,China［Abstract］ObjectiveTodiscussthetreatmenteffectofcomplexhumeralintercondylarfracturewithtotalelbowreplacement.MethodsFromAugust,2005,toApril,2006,3casesofthecomplexhumeralintercondylarfractur
4、eweretreatedwithtotalelbowreplacement,onecaseismale,38yearsold,associatedwithhaemophiliaarthritis,2casesarefemale,66and82yearsolddifferently,associatedwithrhuematoidarthritis.Thepatientassociatedwithhaemophiliaarthritisandthepatient,66yearsold,associatedwithrhuematoidarthritis,acceptedprimarytota
5、lelbowreplacement,anotherpatient,82yearsold,associatedwithrhuematoidarthritis,firstlyacceptedopenreductionandinternalfixation,aftertheoperationfailed,sheacceptedtotalelbowreplacement.3caseshavebeenfollowedfor3to10months,andwereevaluatedwithMayoelbowperformancescore.ResultsThepatientassociatedwith
6、haemophiliaarthritisratedasgood（75point）•Between2casesassociatedwithrhuematoidarthritis,thepatientwhoseopenreductionandinternalfixationfailedratedasgood（85point）,thepatientwhoacceptedprimarytotalelbowreplacementratedasexcellent（95point）.Nolocalpainorprothesislooseningoccuredamong3cases.Conclusion
7、sApplyingtotalelbowreplacementtotreatelderlycasesofcomplexhumeralintercondylarfracture,obviousosteoprosis,withsocomminutedfracturethatIt'sdifficulttobereductedandfixed,andwhosearticularsurfacewereheavilydamaged,wecanat
