闭合复位交锁髓内钉治疗成人肱骨干骨折的疗效

Closed reduction and interlocking intramedullary nail for treatment of adult humeral shaft fracture

目的探讨闭合复位交锁髓内钉治疗成人肱骨干骨折的疗效。方法采用手法牵引闭合复位交锁髓内钉治疗54例成人肱骨干骨折患者。末次随访时采用Neer评分评价肩关节功能,采用Mayo评分评价肘关节功能。结果患者均获得随访,时间3~26个月。骨折均愈合,时间3~8个月。术后均未发生主钉断裂、螺钉松动或脱出情况;2例骨折延迟愈合,通过限制活动延长前臂悬吊时间3周后愈合;3例术前桡神经损伤者均在术后1~3个月恢复。末次随访时,采用Neer评分评价肩关节功能:优34例,良18例,差2例;采用Mayo评分评价肘关节功能:优36例,良14例,可4例。结论闭合复位交锁髓内钉治疗成人肱骨干骨折创伤小、骨折愈合快,疗效确切。

Objective To investigate the effect of closed reduction and interlocking intramedullary nail for treatment of adult humeral shaft fracture.Methods The 54 cases of humeral shaft fractures were treated with manual traction combined with closed reduction and interlocking intramedullary nail fixation.At the last follow-up,shoulder function was evaluated by Neer score,and elbow function was evaluated by Mayo score.Results All patients were followed up for 3~26 months.All the fractures healed within 3~8 months.No major screw fracture,screw loosening or screw withdrawal occurred after operation.In 2 cases,the fracture union was delayed and the forearm sling was extended for 3 weeks by restricting the movement.The symptoms of radial nerve injuries in 3 cases recovered in 1~3 months postoperation.At the last follow-up,Neer score of shoulder joint function was excellent in 34 cases,good in 18 and poor 2;Mayo score of elbow joint function was excellent in 36 cases,good in 14 and poor 4.Conclusions In the treatment of humeral shaft fracture,manual traction combined with closed reduction and interlocking intramedullary nail have the advantages of less trauma,fast fracture healing and curative effect.