顺行交锁髓内钉治疗不稳定型肱骨干骨折的效果

发布时间：2018-02-21 10:15

本文关键词： 肱骨干骨折髓内钉内固定微创　出处：《广东医学》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨交锁髓内钉固定治疗不稳定型肱骨干骨折的疗效。方法应用顺行交锁髓内钉治疗不稳定型肱骨干骨折患者12例,其中男9例,女3例,年龄17~63岁,平均(37.5±5.4)岁。骨折按AO/ASIF分型,B型2例,C型11例。所有患者均采用顺行交锁髓内钉,骨折均采用闭合复位。术后2~3 d即开始行保护下主动功能锻炼,出院后门诊定期随访。采用Neer疗效评分系统评估肩关节功能,采用Mayo肘关节评分标准评价患肢肘关节功能。结果本组12例术后均获得平均(16.0±4.3)个月的随访。所有病例均无伤口并发症及医源性神经、血管损伤。骨折无畸形愈合、延迟愈合及不愈合,平均愈合时间为(10.0±2.5)周。所有病例均无骨折深部感染,其中有2例患者术后出现患侧肩关节疼痛,均于骨折愈合后提前取出髓内钉。按Neer肩关节功能评分标准对患侧肩关节功能情况进行评定:优9例,良3例;按Mayo肘关节评分标准评定,本组病例肘关节功能均为优。结论顺行交锁髓内钉治疗不稳定型肱骨干骨折具有创伤小、并发症少、疗效确切等优点,是治疗不稳定型肱骨干骨折较理想的一种术式,该术式成功的关键是骨折的满意复位及恰当的置钉及锁钉技巧。
[Abstract]:Objective to investigate the effect of interlocking intramedullary nail fixation on unstable humeral shaft fracture. Methods 12 cases of unstable humeral shaft fracture were treated with interlocking intramedullary nail, including 9 males and 3 females, aged 1763 years. The mean age of fracture was 37.5 卤5.4 years. According to AO/ASIF classification, 11 cases had type B type C fracture. All the patients were treated with interlocking intramedullary nail, and all patients were treated with closed reduction. The patients were followed up regularly after discharge. The shoulder function was evaluated by Neer score system. Results 12 cases were followed up for an average of 16.0 卤4.3 months after operation. No wound complications, iatrogenic nerve and vascular injury, no malunion, and no malunion were found in all the 12 cases. Delayed healing and non-union, the average healing time was 10.0 卤2.5 weeks. There was no deep fracture infection in all cases. After fracture healing, intramedullary nail was removed in advance. According to Neer shoulder function score, the shoulder function of affected side was evaluated: excellent in 9 cases, good in 3 cases, and evaluated according to Mayo's elbow joint score standard. Conclusion the treatment of unstable humeral shaft fracture with interlocking intramedullary nail has the advantages of less trauma, less complications and accurate curative effect. It is an ideal method for the treatment of unstable humeral shaft fracture. The key to success of the operation is satisfactory reduction of fracture and proper nailing and locking techniques.
【作者单位】：佛山市顺德区第一人民医院骨科;广东省第二人民医院创伤显微外科;
【分类号】：R687.3

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