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（八）结论
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五、手术处理技巧与建议
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A2. 1 骨折线斜向下内关节外骨折 A2. 2 骨折线斜向下外关节外骨折 A2. 3 横行关节外骨折，分3个亚型：干骺端无明 显移位、干骺端向后移位、干骺端向前移位。
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肱骨远端向下变薄，向两侧变宽、变厚 外髁与肱骨长轴形成向前30～50°的前倾角 内外髁与滑车关节之间形成一薄的骨片；滑车关节略低于肱骨小头 肘关节伸直时呈现10～15°外翻角（男性），20～25°外翻角（女性）， 称生理性携带角（或提携角） 肱骨内外髁各形成一个骨性隆起，即肱骨内上髁(前臂屈肌总肌腱附着点)和 外上髁(前臂伸肌总肌腱附着点)。 内上髁后面是尺神经沟的组成部分
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病历2

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林某，女，右肱骨外髁骨折
X片 （13-b1.1 ）
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肘关节骨折分类
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（二）神经血管问题
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A型

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A型：关节外骨折，其中A1型为骨突撕脱骨折，A2型为简 单干骺端骨折，A3型为干骺端粉碎骨折。 A1 .1 肱骨外髁撕脱骨折 A1. 2 肱骨内髁撕脱骨折，骨折块未嵌入关节； 分3个亚型：无移位、移位、粉碎型 A1. 3 肱骨内髁撕脱骨折，骨折块嵌入关节；





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二、骨折与软组织损伤评估

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（一）肱骨远端骨折的AO分型

肱骨远端骨折目前被广泛接受的是AO分型，其按照关 节外、部分关节内、完全关节内分为A、B、C3大类型， 其更细的分类为27个亚分类，共61小类。
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(一)体位与手术入路
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（三）内植物的选择
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病历1
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沙某----术前片子（13A2.3--干垢端向前移）
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术后X片
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B2 .1 骨折线通过肱骨滑车内侧简单骨折。 B2. 2 骨折线通过肱骨滑车内侧简单骨折、骨折 线通过肱骨滑车 B2. 3 骨折线通过肱骨滑车内侧复杂骨折
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ቤተ መጻሕፍቲ ባይዱ
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四、术前计划
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A3.1 干骺端简单粉碎骨折，分2个亚型：内侧型、 外侧型。 A3.2 干骺端一侧粉碎骨折，分2个亚型：内侧型、 外侧型。 A3.3 干骺端复杂粉碎骨折
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B3 .1 肱骨小头骨折 B3. 2 滑车骨折 B3. 3 肱骨小头与滑车骨折
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（六）术后处理
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