摘要
[目的]评价采用旋入式髓内钉治疗肱骨干骨折的临床疗效，以及临床应用过程中的一些体会。[方法]自2000年1月-2006年2月62例肱骨干骨折采用旋入式髓内钉微创治疗。男38例，女24例，年龄20-58岁，平均36．9岁。闭合性骨折54例，开放性骨折8例。62例肱骨干骨折按AO分类，A型4l例，B型15例，C型6例。对62例肱骨干骨折采用有限切开复位微创旋入式髓内钉固定，术后进行科学合理的康复治疗。随访14-30个月，平均为24个月。[结果]本组62例伤口或切口全部1期愈合，62例骨折均愈合，平均愈合时间为15周。肩关节功能按Ro．driquez-Merchang标准评分，优36例，良20例，中6例，优良率为90．3％。功能恢复良好，效果满意。无感染、医源性骨折、肢体短缩、断钉、脂肪栓塞综合征及周围神经损伤等并发症的发生。[结论]旋入式髓内钉对骨折端的血运影响较小，旋入式髓内钉根据髓腔解剖特点呈髓内中心固定，应力分布更为均匀，具有固定牢靠、手术操作简单、创伤性小、便于早期功能锻炼及有利于骨折愈合的优点。是治疗肱骨干骨折的有效方法，应严格掌握手术适应证及手术时机，值得推广。
[ Objective]To evaluate the clinical efficacy of treatment of humeral shalt fracture with revolving intramedullary nails. [ Method]Sixty-two cases with fracture of humeral shaft were treated by revolving intramedullary nails between January 2000 and February 2006. Their were 38 male cases and 24 female cases. Their average age was 36.9 （ranged 20 - 58 ）. Fiftyfour cases were closed fractures, and eight cases were opened. Sixtyqwo cases with fracture of humeral shaft according to AO classification, 41 cases were type A, 15 cases were type B, 6 cases were type C. Sixty-two patients with the humeral shaft fracture were treated with limited open reduction and minimally invasive internal fixation with revolving intramedullary nails. Scientific and rational rehabilitative treatment was carried out in each case after the operation. All patients were follow-up between 14 months and 30 months. The average follow-up period was 24 months. [ Result]The fracture union occurred in sixty-two patients. The average healing time was 15 weeks. According to Redriquez-Merchang shoulder functional score system, the excellent result was achieved in 36 patients, good in 20 and fair in 6. The excellent and good rate was 90.3%. All cases got good function recovery. The effects were satisfactory. There were no complications in all cases, such as infection, iatrogenic fracture, shortening, break of nail, fat embolism syndrome and peripheral nerve injury. [ Conclusion ] Revolving intramedullary nails for treatment of humeral shaft fracture is effective with litter interference with the blood supply of the bone fracture and with stable immobilization. Due to the abutment of the longitudinal bars along the entire length of the medullary canal wall, highly resistant to the rotational strength was achieved. The advances of revolving intramedullary nails are convenient in operative procedure with little invasive of operation, early function exercise, high raito of fracture healing and safety compared with the normal operative therapy. The ope
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第12期898-900,共3页
Orthopedic Journal of China
关键词
肱骨干骨折
旋入式髓内钉
内固定
微创治疗
humeral shaft fracture
revolving intramedullary nails
internal fixation
minimally invasive treatment
