顺行交锁髓内钉治疗肱骨干骨折不愈合

Treatment of nonunion of fracture humeral shaft with antegrade interlocking nails

目的 评价顺行交锁髓内钉治疗肱骨干骨折不愈合的临床效果。方法 对 13例肱骨干骨折不愈合采用自体髂骨移植 ,顺行Russell Tayler交锁髓内钉治疗。术后行X线片检查和肩关节功能评估。结果 平均随访 18个月 (14～ 2 5个月 ) ,13例均获骨性愈合 ,平均愈合时间 4 3个月 (3～ 7个月 )。肩关节功能 :优 9例 ,良 3例 ,一般 1例。肩关节功能完全恢复 9例 ,3例有来自近端交锁螺钉的肩关节撞击症状。结论 对肱骨干骨折不愈合可采用顺行交锁髓内钉治疗 ;为促进骨愈合 。

Objective To evaluate the clinical effects of antegrade interlocking nailing for humeral shaft nonunions. Methods 13 patients with humeral shaft nonunions were treated by internal fixation of antegrade interlocking nail with autologous bone grafts. The outcomes were assessed by radiographs and evaluation of function. Results It is found that all cases acquired solid bony union with a mean healing time of 4 3 months(3～7 months) through 18 months follow up on average(14～25 months). Shoulder functional results were excellent in 9 cases, good in 3 cases and fair in 1 case. 9 cases had complete recovery of shoulder range of motion, 3 cases had shoulder impingement caused by proximal locking screws. Conclusion Humeral shaft nonunions may be managed by using antegrade interlocking nails;autologous bone grafts and fixation with compressive force on both ends of humeral are necessary for enhancing bone healing.