新型内固定系统治疗肱骨多节段骨折的临床研究

The Clinical Research of New Fixation System for Treatment of Multi-segmental Fractures of Humerus

目的：探讨一种新型内固定系统-桥接组合式内固定系统治疗肱骨多节段骨折的可行性及早期临床效果。方法：选取本科2010年4月-2013年1月采用桥接组合式内固定系统治疗13例肱骨多节段骨折患者，记录患者的手术时间、术中出血量、骨折愈合时间，肩关节Neer评分及肘关节HSS评分、并发症发生情况等。结果：本组13例患者，手术时间55~180 min，平均90 min；术中出血量80~500 mL，平均200 mL。13例患者骨折均愈合，愈合时间8~16周，平均12.5周。并发症：所有患者均未出现桡神经损伤，骨折端无移位，内固定无松动、拔钉及断钉。术后3个月肢体功能评价：肩关节功能评定参照肩关节Neer评分标准进行，评价结果：优12例，良1例，优良率为100%。肘关节功能评定参照肘关节HSS评分标准进行，评价结果：优11例，良1例，中1例，优良率92.3%。结论：桥接组合式内固定系统应用于肱骨多节段骨折操作灵活、固定效果可靠、并发症少，理论上较LCP更具优势，其远期疗效、并发症及理论上的优势，尚需大量临床病例观察和对比性实验证实。

Objective：To investigate the feasibility and early clinical effects of a new fixation system-the bridge combined internal fixation system for multi-segmental humeral fractures.Method：13 patients with multi-segmental humeral fractures in our department from April 2010 to January 2013 treated ORIF with the bridge combined internal fixation system were selected,the operation time,intraoperative blood loss,fracture healing time,shoulder and elbow Neer score HSS score,complications and so on of all patients were recorded.Result：The operative time was 55-180 min,90 min in average;blood loss was 80-500 mL,an average of 200 mL.13 patients with fractures were healed from 8 to 16 weeks,an average of 12.5 weeks.Complications：no patient experienced radial nerve injury,non Loss of fracture reduction,internal fixation without loosening,pulling nails and broken nails.Three months after the evaluation of limb function：shoulder function assessed according to Neer rating criteria：excellent in 12 cases,good in 1 case,good rate was 100%.Elbow function assessment according to HSS score criteria：excellent in 11 cases,good in 1 case,medium in 1 case,good rate was 92.3%.Conclusion：The bridge combined internal fixation system used in treatment of multi-segmental fractures of humerus has advantage of flexible operation,reliable fixed effects,fewer complications.In theory, it is better than LCP,its long-term efficacy,complications and theoretical advantages,still need further observation and comparative experiments to confirm.