肱骨干骨折术后桡神经损伤的诊治分析

Diagnosis and treatment of radial nerve injury following internal fixation for humeral shaft fracture

目的探讨肱骨干骨折钢板内固定术后发生桡神经损伤的病因特点及治疗分析。方法对我科自1997～2003年间收治的15例肱骨干骨折钢板内固定术后发生桡神经损伤病例的致病原因、临床表现、诊治方法及预后转归进行回顾性分析。结果所有病例随访6～18个月。所有病例自觉症状消失,伸腕、伸指肌力恢复至Ⅴ级,肌电图复查神经传导速度和潜伏期恢复正常范围。结论过度牵拉、粗暴操作和钢板卡压是医源性桡神经损伤的三大主要原因。早期诊断和早期手术松解可使神经功能完全恢复。

Objective To explore the etiology and treatmen t of radial nerve injury following in ternal fixa-tion for humeral shaft fracture.Methods 15patients were treated in our department from 1997to 2003for radial nerve injury following steal-plate internal fixation.They were selected for this study and followed up from6to 18months.Their injury cause,clinica l manifestation,methods of treatme nt,diagnosis and prognosis were retrospec-tively analyzed.Results The symptoms of nerve injury disappeared in all patients.Their muscle strength of wrist and digit extension returned to grad e V.The electromyogram showed that t heir nerve conduction velocity and l atent period returned to normal.Conclusions Excessive traction,careless manip ulation and steel plate compression are the main causes for iatrogenic radia l nerve injury.The nerve function can be completely recovered with early diag-nosis and early neurolysis.[