小切口复位交锁髓内钉固定治疗肱骨干骨折

Treatment of Humeral Shaft Fractures by Limited Open Reduction and Russell-Taylor Interlocking Intramedullary Nail

目的:观察交锁髓内钉(RT钉)治疗肱骨干骨折的临床效果。方法:肱骨干骨折患者40例,根据治疗方法不同分为带锁髓内钉组(A组)和钢板内固定组(B组),每组20例。分别比较两组影像学骨折愈合时间、术后桡神经损伤、感染、术后患肢肿胀情况及术后肩关节功能等。结果:术后随访8～28个月,两组的临床愈合时间、放射学骨折线消失时间、术后感染率、肩关节功能评分等,均无统计学意义(P>0.05)。B组术后患肢肿胀时间、桡神经麻痹发生率均多于A组(p<O.05)。结论:交锁髓内钉治疗肱骨干骨折具有创伤小、内固定牢靠、骨折愈合率高及功能恢复快的特点。

Objective：To summarize the effectiveness of Russell-Taylor interlocking intramedullary nail（RT nail）for humeral shaft fractures.Methods：40 patients with humeral shaft fractures were treated surgically.20 cases were treated with interlocking intramedullary nail （IIN） fixation,20 cases were treated with plate fixation（PLT）.Clinical outcome measurements included fracture healing,radial nerve injury, i nfection,shoulder function according to Neer＇s score and soft tissue engorgement.Results：The average follow-up time was （8 months to 28 months）.20 cases those were treated with PLT fixation,the average time of healing was （14.3±2.6） weeks;20 cases those were treated with IIN fixation,the average time of healing was （12.8±2.7） weeks. 100% of patients had good to excellent postoperative shoulderfunctin,cases displayed postoperative union,segmental and comminuted fractures.Five cases displayed secondary postoperative radial never palsy in PLT group,but no ease has iatrogenic injury in IIN group.The Swollen limbs persisted of PLT group over 11 weeks,but swollen limbs persisted was 4 weeks in IIN group（P〈0.05）.Conclusion：RT nail is more effective in the humeral shaft fractures.