摘要
目的:回顾性分析比较交锁髓内钉与加压钢板治疗肱骨干骨折的疗效。方法:手术治疗135例肱骨干骨折,其中肱骨加压钢板内固定59例,交锁髓内钉固定76例,比较两种方法的手术时间、住院时间、术中出血量等疗效指标和术后并发症发生情况以及功能恢复情况。结果:髓内钉组术中出血量平均为125ml,少于钢板组的212ml,差异有统计学意义(P<0.05),而在手术时间及住院时间方面,两者之间差异没有统计学意义(P>0.05)。髓内钉内固定组1例发生骨不连,钢板组有4例出现骨不连接。桡神经损伤钢板与髓内钉分别为7例、2例,血管损伤分别为1例、0例,骨折畸形愈合两组各1例,肩功能功能障碍分别为3例、6例,所有病例未发生骨感染。术后长期随访,髓内钉组的优良率为89.5%,钢板组为88.1%,两者差异有统计学意义(P<0.05)。结论:与钢板相比,髓内钉具有术中出血量少,桡神经损伤发生率低等优点,应作为肱骨骨折的首选治疗方法。
Objective：To compare the therapeutic effect between intramedullary nail and plate in treating humeral shaft fractures. Methods：One hundred and thirty-five patients with humeral shaft fracture were divided into plate group （59 cases） and intramedullary nail group （76 cases）. Operation duration, hospitalization time, blood loss, occurrence of postoperative complications and functional recovery between the two groups were observed. Results：The mean blood toss was 125ml in intramedullary group and 212ml in plate group, which was significantly different （P〈0.05）. However, there was no statistical difference in hospitalization time,and operation duration between the two groups （P〉0. 05）. Nonunion occurred in 4 cases in plate group and 1 case in intramedullary nail group. Seven cases of radial nerve injury happened in plate group and 2 cases in intramedullary nail group. One case of blood vessel injury occurred in plate group. The malunion occurred in 1 case in each group. The shoulder joint dysfunction occurred in 3 cases in plate group and 6 cases in intramedullary nail group. No infection happened in either group. Long-term postoperative follow-up indicated that the excellent and good rate was 89.5% in intramedullary nail group and 88.1 % in plate group, and the difference was statistically significant （P〈0. 05）. Conclusion：Intramedullary nail has more advantages over plate such as less blood loss and low occurrence of radial nerve injury, and should be the first choice for humeral shaft fracture.
出处
《中国中医骨伤科杂志》
CAS
2009年第7期26-27,共2页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
肱骨干骨折
内固定
髓内钉
钢板
Humeral shaft fractures
Internal fixation
Intramedullary nail
Plate
