Analyze The Factors Influencing The Effect Of Elbow Joint Function Of Type C Distal Humeral Fractures After Operation

Objective Analysising the factors influencing the effect of elbow joint function of type C distal humeral fractures after operation to provide the basis for clinical treatment options.Methods From September 2009 to December 2014, A retrospective survey analysis on the Second Hospital of Tang Shan, which is in He bei Province, has gone for distal humerus fracture patients who were treated with Internal fixation with double plates and received follow-up of 54 patients, including 29 males and 25 females, age from 16 to 60 years, mean age(44.61 ± 6.65) years old, The causes of injury: fall injury 12 cases; traffic incidents 35 cases; falling from a height 7 cases. According to the fracture type is divided into: 19 cases with open fracture, closed fracture in 35 cases; According to the AO classification: Type C1 15 cases; Type C2 25 cases; Type C3 14 cases. According to the difference of the operative approach, olecranon osteotomy approach 21 cases; the tricepssparing approach 33 cases. AS far as consulting the related literature in recent years, we know that type of the fracture, waiting time before operation, approach of the operation,the time for the operation and the time begin function exercise have something to do with elbow joint function after the operation of type C distal humeral fracture. In the research,type of the fracture, waiting time before operation, approach of the operation, the time for the operation and the time begin function exercise of the 54 cases were recorded, then organizing,analyzing and including the information collected. With differences of the data and the observation index as the basis, Measurement data using mean soil standard deviation, represented by the percentage of count data, using the chi square test, multi factor Logistic regression analysis, SPSS 20 software was used in statistical treatment.Using analysis of variance test, P <0.05 was considered statistically significant.Result 54 cases were followed up for 6 to 12 months, with an average follow-up time(9 ± 3.06) months. The patients had no postoperative infection, neuro vascular injury,wound bad healing, 1. There was no statistical significance in the patients with operation time(P>0.05).2. There was significant difference in the fracture types(P<0.05), the excellent and good rate of the closed fracture group is higher than the open fracture group.3. There was significant difference in waiting time before operation(P<0.05), patients with early operation(within 7 days) group has the higher rate than patients with advanced operation group in the excellent and good rate. 4. There was significant difference in the operative approach(P<0.05), patients with olecranon osteotomy group has the higher rate than patients with the triceps-sparing approach group in the excellent and good rate. 5. There was significant difference in the time begin function exercise(P<0.05), patients with early functional exercise(less than 10 days) group was higher, than late(more than 10 days) to start functional exercise in patients in the excellent and good rate.Conclusion Type of the fracture, waiting time before operation, approach of the operation, the time for the operation and the time begin function exercise have something to do with the postoperative elbow joint function, and the operation time has no obvious influence on the elbow joint function,For the open fracture patients, the soft tissue injury should correctly evaluate early. Making correct treatment scheme and exhaustive debridement so that the patients can be ready for the two-stage operation. Considering the early operation can reduce the occurrence of heterotopic ossification, After injury, we should make early operation on patients with a comprehensive understanding of the patient’s condition.as far as type C distal fracture of humerus is concerned, the tricepssparing approach will be the first choice which make small trauma, less bleeding, small damage on the original anatomical structure and is conducive to the early functional exercise of patients. Considering the exposure of type C3 distal fracture of humerus was difficult,the surgical approach can be changed to the olecranon osteotomy approach,because its exposure area is bigger than the triceps-sparing approach. Early postoperative functional exercise is of great importance to the elbow joint function of patients. Based on stable internal fixation, the doctor should guide the patients with early postoperative functional exercise. This allows patients to get the better elbow joint function better and improve the life quality of the patients.