旋入自锁髓内钉与交锁髓内钉治疗肱骨干骨折的临床对比研究

Comparative study of humeral shaft fracture fixation: self-locking intramedullary nail and intramedullary nail

目的比较旋入自锁髓内钉﹙旋入钉﹚与交锁髓内钉固定对肱骨干骨折的治疗效果。方法收集我院2008年7月~2011年7月54例肱骨干骨折患者分别采用旋入钉与交锁髓内钉内固定治疗。旋入钉组30例,交锁髓内钉组24例。比较两组在手术时间、术中出血量、骨折愈合时间、肩关节功能及手术并发症等的区别,根据结果进行统计分析。结果旋入钉组在手术时间及术中出血量上明显少于交锁髓内钉组。而在骨折愈合时间、术后肩关节功能等方面无明显差异。交锁髓内钉组术后出现3例桡神经损伤病例,均采取保守治疗,术后6个月后,患肢功能均完全恢复。1例伤口出现表面感染,予每日伤口碘伏换药,清除坏死组织后,1月后伤口愈合。两组病例均未出现骨折延迟愈合或者不愈合。结论旋入钉治疗肱骨干骨折手术操作简单,手术创伤小,并发症少,治疗效果满意,值得临床推广。

Objective To compare clinical outcomes of self-locking intramedullary nail and intramedullary nail ﹙IMN﹚ for the management of humeral shaft fracture.Methods Collected 54 patients with fracture of humeral shaft treated with self-locking intramedullary nail﹙30 cases﹚ or IMN﹙24 cases﹚ from July 2008 to July 2011.Clinical outcome measurements included operation time,blood loss,fracture healing,shoulder function,and other complications.Results There were significant difference in operation time and blood loss between the two groups,but not in fracture healing and shoulder function.There was 3 radial nerver palsy and 1 super cial wound infection in IMN groups.All of them was union.Conclusion The self-locking intramedullary was more simple,less trauma,fewer complications,less effect on shoulder than IMN.The surgical treatment results were satisfactory and worth to promotion in clinical.