旋入式自锁钉及经皮自体骨髓移植微创治疗肱骨骨折

Revolving self-locking nail and percutaneous autogenous bone marrow transplant Minimally invasive treatment of humeral fracture

目的 观察旋入式自锁钉及自体骨髓移植治疗肱骨干骨折的临床效果,探讨肱骨干骨折的微创治疗方法.方法 回顾性分析自2003年4月至2006年3月微创法治疗肱骨骨折36例,其中闭合骨折30例,其中开放性骨折6例;单纯旋入式自锁钉固定11例,旋入式自锁钉加自体骨髓移植25例.肩部小切口,术中均不扩髓,术后不用外固定,并早期能锻炼;自体骨髓移植时间以术后1～2月内1次,可2～3次,不住院.结果 经6～18个月术后随访,骨折全部愈合,平均愈合时间8个月,其中加用自体骨髓移植比单纯使用自锁钉骨折愈合时间提前两个月左右.肩、肘关节功能无明显障碍,上肢功能恢复正常.结论 旋入式自锁钉治疗肱骨骨折,固定可靠,可不扩髓,联合使用经皮自体骨髓移植,可促进骨折愈合,缩短骨折愈合时间;两种治疗方法操作简单,创伤小,骨折愈合快,功能恢复好,是微创治疗肱骨干骨折的有效方法.

Objective To summarize the clinical effect of revolving self-lock nails and percutaneous autogenous bone marrow transplantation for humerus shaft fracture, and discuss the minimally invasive treatment methods.Methods We retrospectively analyzed from April 2003 to March 2006 the Minimally invasive therapy in 36 cases, (closed fracture 30 cases, open fracture 6 cases);the simplicity revolving self-lock nails 11 cases, The revolving self-lock nails and autogenous bone marrow transplant 25 cases, using shoulder mini-incision operation, non-expanding the marrow, No use fixed after operation ,and the early time could exercise.From the autogenous bone marrow time after operation in 1 to 2 month, may 2-3 times. Need not hospitalized. Results Follow-up survey after 6-18 months,the fracture are all osteologically restituted ,the average time 8 months.in which adds with transplant compared to self-lockednail bone fracture unions advance two months.No functional disturbance of shoulder joint and cubital articulation ,and function of upper extremity have recovered. Conclusion Revolving self-locking nail and percutaneous autogenous bone marrow grafting minimally inavasive treatment of humeral fracture is an operation with little wound, it does little to the hemodynamics,and the reposition of the fractured is steady, the restitution of the fractured is fine,and the clinical effect is satisfactory.