自锁髓内钉在治疗肱骨干骨折中的应用

Application of auto-lock intramedullary nail in the treatment of fracture of humeral shaft

目的探讨肱骨自锁髓内钉治疗肱骨干骨折的疗效。方法对我院于2002年1月～2007年10月收治52例肱骨干骨折采用肱骨自锁髓内钉治疗进行回顾性分析。本组病例中新鲜骨折46例,骨不连6例。结果本组病例平均随访14个月,50例骨折愈合,骨折愈合率96%,骨折愈合时间为3～7个月,平均4个月。2例骨不愈合经第二次手术植骨愈合。肩肘关节功能:优39例,良12例,差1例(肩部疼痛、肩关节僵硬),肩肘关节功能优良率98。结论肱骨自锁髓内钉手术操作简便,创伤小,固定可靠,允许早期功能锻炼,并发症少,疗效的满意率高,可有效治疗肱骨干骨折,尤其适合多段骨折,粉碎性骨折和骨折不愈合。

Objective To investigate the curative effects of auto-lock intramedullary nail for treatment of fracture of humeral shaft. Methods From January 2002 to October 2007,52 cases with fracture fo humeral shaft received treatment of humeral auto-lock intramedullary nail were analyzed retrospectively. Among them, 64 cases were fresh fracture and 6 cases were nonumion. Results In this group, the patients were followed-up average for 14 months. The fractures were union in 50 cases and bone union rate was 96%. Bone union time was 3 to 7 months （Average 4 months）. Bone nonunion was in 2 cases, but via secondary operation of bone grafting, the fracture of 2 cases were union. Shoulder and elbow joint function ：excellent good and poor were 39,12 cases and 1 case respeetively. The cxcellent and good rates were 98%. Conclusion In the treatment of fracture of humeral shaft, humeral auto-lock intramedullary nail possesses many advantages, including simple operative manipulation, less trauma, reliable fixation, fewer complications and permitting early function training. It can effectively treat the fracture of humeral shaft, esecially in the multi-segmental fracture, comminuted fracture and nonunionn.