带锁髓内钉加刻槽后钢丝固定治疗肱骨粉碎性骨折

Treatment of Comminuted Humeral Fractures with Interlocking Intramedullary Nailing and Steel Wire

目的探讨带锁髓内钉加刻槽后钢丝固定治疗肱骨粉碎性骨折的临床疗效。方法2002年1月—2007年1月,采用带锁髓内钉加刻槽后钢丝固定治疗肱骨粉碎性骨折患者32例,手术采用开放复位,骨块刻槽钢丝固定后顺行置入髓内钉,若骨块间隙>5 mm,采用自体骨条或冷冻干燥异体骨一期植骨。结果平均随访时间21.4个月,骨折全部愈合,平均愈合时间为4个月,所有患者肩肘关节功能恢复良好,无感染及医源性神经血管损伤。结论带锁髓内钉加刻槽后钢丝固定为治疗肱骨粉碎性骨折的有效方法。

Objective To study the clinical application of interlocking intramedullary nailing plus steel wire to comminuted humeral fractures and its efficacy. Methods Thirty-two cases with comminuted humeral fracture were treated with interlocking intramedullary nailing and steel wire by opened reduction from Jan 2002 to Jan 2007. Autogenous iliac and allogeneic bone grafting would be performed if the distant between comminuted bone pieces was more than 5 mm. Results The average follow-up time was 21.4 months. All the patients not only achieved osseous union with an average healing time of 4 months, but recovered good function of shoulder joints and upper extremities. No patient experienced any nosocomial permanent neurological deficit or blood vessel injury. Conclusionl nterlocking intramedullary nailing plus steel wire fixation is an effective approach to the treatment of comminuted humeral fractures.