交锁髓内钉手术治疗肱骨干骨折

Treatment of humeral shaft fractures with interlocking intramedullary nails

目的介绍采用交锁髓内钉手术治疗肱骨干骨折。方法自1999年1月～2003年1月采用交锁髓内钉(远端不交锁)治疗肱骨干骨折36例。男28例,女8例;年龄19～59岁,平均38岁。AO分型,A型24例,B型11例,C型1例,均采用闭合复位、顺行插钉技术,远端不交锁,术后第2天肩肘带保护下开始功能锻炼,不采用其它外固定。结果随访26例,随访时间3～38个月,平均20个月,所有病例伤口Ⅰ/甲愈合,骨折无延迟愈合及不愈合。平均愈合时间9周,术后肩肘关节功能恢复良好。结论交锁髓内钉是治疗肱骨干骨折较好方法,远端可不交锁。

Objective To describe a surgical method to treat humeral shaft f ra ctures with interlocking intramedullary nails. Methods From January 1999 to Janu ary 2003, 36 cases of humeral shaft fractures were treated with interlocking nai ls (without distal locking screws). 28 were males and 8 were females. Their aver age age was 38 years old (ranging 19 to 59 years). According to the AO classific ation, there were 24 cases of type A and 11 cases of type B and 1 case of type C . All were closed fractures and treated with manual reduction. With a sling give n to the patients postoperatively, shoulder and elbow joint exercise was allowed . Results 26 cases were followed up. The mean follow-up period was 20 months (r anging 3 to 38 months). There was no delayed union, nonunion, malunion, or infec tion in all the cases. The average period of bone healing was 9 weeks. All the p atients had satisfactory functions of the shoulder and elbow. Conclusion The int erlocking intramedullary nailing (without distal locking screws) is a safe and e ffective technique in treatment of humeral shaft fractures.