顺行肱骨髓内钉治疗急性肱骨干骨折

Antegrade Interlocking Nailing of Acute Humeral Shaft Fractures

目的评价应用肱骨髓内钉治疗肱骨干骨折的临床疗效。方法从1999年2月到2004年5月,本科应用肱骨髓内钉治疗68例急性肱骨干骨折,其中男41例,女27例,平均年龄37岁(年龄范围20～73岁)。11例(16%)为开放性,6例(9%)有术前桡神经瘫。66(97%)例一期愈合,2例(3%)植骨后愈合。3例(4%)发生医源性桡神经瘫,均为一过性。63例(93%)肩关节功能恢复良好,1例(1%)有钉尾撞击症状,全部病例术后肘关节功能恢复良好。结论顺行肱骨髓内钉治疗急性肱骨干骨折是一种固定可靠,愈合率高,并发症少,功能恢复良好的方法。

Objective To evaluate the clinical effects of surgical treatment with acute humeral shaft fractures, using antegrade humeral intramedullary nail. Methods Between febulary 1999 to may 2004,68 acute humeral shaft fractures in 68 patients were treated with antegrade humeral nailing. Above all, 41 were male and 27 were female, with a average age of 37(range from 20 to 73). Of all the fractures, 11 cases(16%) were open, 66cases(97%)united primarily, and 2 cases(3%) united after bone grafting. 6(9%) patients had preoperative radial nerve palsy. 3(4%) iatrogenic radial nerve palsies accured, all were transient. Full shoulder function returned in 63(93%)patients, 1(1%) patient had impingment from a prominent nail. All patients regained full elbow function. Conclusions Antegrade humeral intramedullary nailing is a good methods for the treatment of acute humeral shaft fractures, with well fracture stability, excellent union rate, rare complications and satifactional recovery of function with the shoulder and elbow joint.