交锁髓内钉在治疗肱骨干骨折中对肩关节功能的影响

Shoulder Dysfunction Caused by Locking Nail for Humeral Shaft Fractures

目的 报告 1996～ 1998年间应用多种型号的交锁髓内钉治疗肱骨干骨折 2 5例的疗效。方法 对肱骨干骨折 2 5例采用交锁髓内针治疗。得到随访 2 1例。随访时间 8～ 32个月 ,平均 17个月。伤者年龄 18～ 70岁 ,平均 39岁。骨折类型 :横断形9例 ,粉碎形 2例 ,斜形 5例 ,螺旋形 5例。肱骨上 1/3骨折 4例 ,中 1/3骨折 16例 ,下 1/3骨折 1例。结果 按Neer评分法测定肩关节功能 ,13例 (6 2 % )合并有不同程度的功能障碍。结论 认为目前的交锁髓内针在治疗肱骨干骨折时会损伤到肩袖 ,因此在选用时应慎重。

Objective This article reported the effect of twenty-five fractures of humeral shaft treated by locking nail fixation between 1996 and 1998 Methods Twenty one cases with humeral shaft fracture were treated by locking nail Functional assessment was carried out on 21 patients at mean follow-up of 17 months(8 to 32) There were twelve male and nine female patients,and the average age was thirty-nine years(18 to 70) The types of fractures:comminuted 2 cases,transverse 9 cases,oblique 5 cases,spiral 5 cases The level of fractures:proximal third 4,middle third 16,distal third 1 Results The shoulder function was assessed by the Neer score Dysfunction of the shoulder developed in thirteen(62%) of the patients who had fractures treated with proximally directed nails This paper analyzed the causes of the nail damaging the shoulder and reviewed the shoulder anatomy Conclusion The authors consider that the locking nail should be prudently chosen in the treatment of humeral shaft fractures because it might endanger the shoulder function