闭合复位顺行磁力导航交锁髓内钉固定治疗肱骨干骨折

Closed reduction and fixation with anterograde magnetic navigated interlocking intramedullary nail for treatment of humeral shaft fracture

目的探讨闭合复位顺行磁力导航交锁髓内钉固定治疗肱骨干骨折的临床疗效。方法采用闭合复位顺行磁力导航交锁髓内钉固定治疗16例肱骨干骨折患者。记录手术时间、术中出血量、骨折愈合时间及并发症发生情况;末次随访时采用Neer评分、Mayo评分评价肩肘关节功能。结果手术时间70~125 min,术中出血量70~150 ml。术后切口均一期愈合,无切口感染、脂肪栓塞以及继发性神经、血管损伤等并发症发生。患者均获得随访,时间6~18个月。骨折均愈合,时间12~20周。无内固定物松动或断裂。末次随访时,根据Neer评分评价肩关节功能:优14例,良2例;根据Mayo评分评价肘关节功能:优14例,良2例。结论闭合复位顺行磁力导航交锁髓内钉固定治疗肱骨干骨折具有创伤小、安全、骨折愈合快及肩、肘关节功能恢复满意等优势。

Objective To investigate the clinial efficacy of humeral shaft fracture treated with closed reduction and fixation with anterograde magnetic navigated interlocking intramedullary nail.Methods The 16 patients of humeral shaft fracture were treated by closed reduction and fixation with anterograde magnetic navigated interlocking intramedullary nail.Operation time,intraoperative blood loss,fracture healing time and complication incidence situation were recorded.At the last follow-up,Neer score and Mayo criteria were used to evaluated the function outcome of the shoulder and elbow,respectively.Results The operation time was 70~125 min,intraoperative blood loss was 70~150 ml.All incisions gotⅠ-stage healing.No complication such as infection,fat embolism and secondary nerve,vascular injury occurred.All patients were followed up for 6~18 months;fracture healing time ranged from 12~20 weeks,without loosening or fracture of internal fixation.At the last follow-up,shoulder joint function was evaluated according to Neer score:excellent in 14 cases and good in 2 cases.Elbow function was evaluated according to Mayo score,and 14 cases were excellent and 2 cases was good.Conclusions Closed reduction and anterograde magnetic navigated interlocking intramedullary nail fixation for humeral shaft fracture has the advantages of less trauma,safety,fast fracture healing and satisfactory functional recovery of the shoulder and elbow.