Open Reduction and Internal Fixation of Coronal Shear Fractures of the Distal Humerus

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  • Nishiwaki Masao
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital
  • Ishikura Kayoko
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital
  • Utashima Atsushi
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital
  • Terasaka Yukinori
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital
  • Kiyota Yasuhiro
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital
  • Kushima Yuu
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital
  • Inaba Naoto
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital
  • Horiuchi Yukio
    Hand and Elbow Surgery Center, Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital

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Other Title
  • 上腕骨遠位端coronal shear fractureの治療成績

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Description

上腕骨遠位端coronal shear fracture 11例12肘の治療成績を後向きに調査した．Dubberley分類type 1A，2Aは拡大外側アプローチでheadless screwで固定し，type 3Bで粉砕高度な場合は肘頭骨切りによる後方進入でplate，screw，Kirschner鋼線等を組み合わせて固定した．最終調査時の肘関節平均自動屈曲130° ，伸展-13° ，JOA-JES score平均92点であった．変形が残った6肘はすべてtype 2B，3Bであり， 4肘は小頭が中枢に転位して癒合し，1肘は偽関節，1肘は小頭と滑車の一部が壊死して関節症変化を生じた．Type Aはheadless screw固定が有用であったが，type 3Bではheadless screwは剪断力で傾き，plate固定ではscrewが薄い骨片を把持できず，良好な固定性獲得は困難であった．

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