目的 探究经尺骨鹰嘴截骨入路与肘关节外侧入路脱位法复位内固定治疗肱骨远端冠状面骨折的疗效，并进行对比分析。 方法 选择2016年3月至2021年3月我院收治的62例脱位法复位内固定治疗肱骨远端冠状面骨折患者，按照手术入路方式不同分为对照组（n = 32，经肘关节外侧入路）和研究组（n = 30，经尺骨鹰嘴截骨入路），比较两组手术一般情况、肘关节活动度、肘关节功能（Mayo评分）及并发症。 结果 两组出血量、手术时间比较差异无统计学意义（P > 0.05），研究组切口长度高于对照组（P < 0.05）；术后1、6、12个月，研究组患者Mayo评分均高于对照组（P < 0.05）；术后12个月，研究组肘关节屈、伸活动度高于对照组（P < 0.05）；研究组随访12 ~ 27个月，平均（14.8 ± 2.2）个月，骨性愈合时间6 ~ 10周，平均（10.8 ± 2.7）周；对照组随访12 ~ 31个月，平均（15.5 ± 3.1）个月，骨性愈合时间8 ~ 21周，平均（12.4 ± 3.2）周，研究组骨性愈合时间低于对照组（P < 0.05），随访期间两组均未出现伤口感染、血管神经损伤情况，研究组发生关节僵硬、骨折延迟愈合、创伤性关节炎、异位骨化概率与对照组比较差异无统计学意义（P > 0.05）。 结论 与肘关节外侧入路比较，经尺骨鹰嘴截骨入路进行脱位法复位内固定治疗肱骨远端冠状面骨折患者肘关节功能恢复更好，且并发症发生概率不高，短期疗效满意。

Objective To compare the clinical efficacy of olecranon osteotomy approach vs lateral elbow approach for the treatment of transarticular coronal shear fracture of the distal humerus with reduction and internal fixation. Methods Sixty-two patients with transarticular coronal shear fracture of the distal humerus receiving open reduction and internal fixation surgery in our hospital from March 2016 to March 2021 were enrolled and assigned to two groups according to different surgical treatment methods. Control group （n = 32） received lateral elbow approach and treatment group （n = 30） received olecranon osteotomy approach. The general data， range of motion of the elbow joint， Mayo elbow performance score （MEPS）， and complications between two groups were compared. Results No statistical difference was found in surgical duration and bleeding volume between the two groups （P > 0.05）， while the incision length of treatment group was longer than that of the control group （P < 0.05）. Compared with the control group， Mayo scale was higher in treatment group at postoperative 1， 6 and 12 months （P < 0.05）. Compared with baseline data， the elbow flexion and extension range of motion improved in both groups at postoperative 12 months （P < 0.05）. Treatment group was followed up for 12 to 24 months， with a mean of （14.8 ± 2.2） months， and the bone healing time was 6 to 10 weeks with a mean of （10.8 ± 2.7） weeks. In control group， the follow up time ranged from 12 to 31 months， with a mean of （15.5 ± 3.1） months， and the bone healing time was 8 to 21 weeks with a mean of （12.4 ± 3.2） weeks. Treatment group had notably decreased time on bone healing compared with control group （P < 0.05）. No wound infection or vascular and nerve injury occurred in either group during the follow-up period. The incidence rate of joint stiffness， delayed fracture healing， traumatic arthritis， and heterotopic ossification yielded no statistical difference between the two groups （P > 0.05）. Conclusion Compared with lateral approach， the treatment of transarticular coronal shear fracture of the distal humerus with reduction and internal fixation via olecranon osteotomy approach had better elbow joint recovery， less complications and better short-term effects.