可膨胀髓内钉系统治疗骨质疏松性肱骨干骨折的临床评价

Clinical evaluation of expandable nail system for osteoporotic humeral shaft fractures

目的探讨可膨胀髓内钉系统治疗骨质疏松性肱骨干骨折的疗效。方法采用可膨胀髓内钉治疗骨质疏松性肱骨干骨折32例,记录并发症、骨折愈合时间和肩关节功能。结果32例均获随访,时间12～24个月,骨折均愈合,时间12～32周。根据Neer肩关节功能评定标准:优23例,良6例,可3例,优良率90.63%。无感染及神经损伤等并发症,有2例术中发生了骨折线的扩大,3例术后出现肩峰撞击综合征。结论可膨胀髓内钉无需锁钉,而是通过膨胀稳定骨折端,固定牢靠,对骨折端血运影响小,是治疗骨质疏松性肱骨干骨折较理想方法。

Objective To evaluate the methods and clinical effects of expandable nail system for osteoporotic humeral shaft fractures. Methods The system was used to manage 32 unstable humerus shaft fractures in osteoporotic bone. The complications, the bone healing time and the function of the shoulders were recorded. Results All the patients underwent smoothly wound healing process without infections or dehiscences. The results of 32 patients were evaluated at the follow up ranged from 12 to 24 months. All 32 fractures united uneventfully within a bone healing time ranged from 12 to 32 weeks. According to the Neer＇ s scoring system, functional recovery of shoulder of all cases were excellent in 23 cases, good in 6, fair in 3, and the excellent and good rate was 90. 63 %. There were the expansion of the fracture gap in 2 cases and acromial impingment syndrome in 3 cases. There was no other complication in all cases, such as infection, peripheral nerve injury. Conclusions Expandable nail system does not depend on interlocking screws which axial and rotational stability is instead achieved by nail expansion. Expandable nail system provides reliable fixation, compromises little fracture site vascular support, which is ideal for osteoporotic humeral shaft fractures.