不同手术入路对肱骨中下段骨折治疗的影响

Effects of different approaches on the management of the middle and distal thirds of humeral fractures

目的 评价不同手术入路对肱骨中下段骨折治疗的影响。方法 回顾性地将1994年1月～2000年1月93例肱骨中下段骨折病人作对照研究,45例采用前外侧入路,48例采用后侧入路。结果 前外侧入路有12例并发桡神经损伤,骨不愈合5例;后侧入路有4例并发桡神经损伤,骨折不愈合2例。经x^2检验,前者具有显著性差异(P=0.027),而后者无显著性差异(P=0.258)。结论 后侧入路对于肱骨中下段骨折是一种较好的和安全的入路。

Objective To evaluate the effects of different approaches on the management of the middle and distal thirds of the humeral fractures.Methods 93 patients were divided into two groups randomly.48 cases were treated by the posterior approach and 45 cases by the anterolateral approach.Results In the anterolateral approach group complication of radial nerve injury occurred in 12 cases and nonunion in 5 cases.While in the posterial approach group Complication of radial nerve injury in 4 cases and nonunion in 2 cases.No significant difference was found between the two groups in terms of associated bone union,while significant difference existed between the two groups in terms of associated radial nerve injury.Conclusion The posterior approach is a better choice and safer in management of the middle and distal thirds of the humeral fractures.