髓内外固定治疗肱骨干骨折的疗效分析回顾

发布时间：2018-12-19 20:19

【摘要】：目的:探讨钢板螺钉内固定(plate internal fixation,PIF)与交锁髓内钉(interlocking intramedu llary nail,IIN)两种内固定方式治疗肱骨干骨折的差别和疗效。方法:回顾性分析2013年3月至2014年10月山东中医药大学附属医院(东院区)骨科病房收治的50例肱骨干骨折患者的临床资料。将样本资料以随机分组方式分为髓内治疗组22例,髓外治疗组28例。分别以相应的内固定方式进行手术治疗。术后观察指标包括:两组手术时间、术中出血量、骨折愈合情况、术后并发症。所得数据采用统计软件SPSS17.0进行分析。结果:本次研究共收集病例50例,所有病例皆获得随访。采用交锁髓内钉固定的22位患者平均骨折愈合时间为98.000±6.89天。未发生骨折的延迟愈合或者不愈合。2肩关节活动受限约0-100°,疗效评价结果为:优16例,良4例,优良率达到90%。采用钢板内固定的28位患者平均骨折愈合时间为106.142±6.29天,其中1例术后刀口延迟愈合。疗效评价结果为:优20例,良6例,达到92%优良率。结论:本次研究表明,采用髓内固定和髓外固定治疗肱骨干骨折均可取得较好疗效。使用锁定钢板时需注意避免医源性损伤桡神经;使用交锁髓内钉时需注意将钉尾埋入大结节皮质并保护肩袖,以免发生肩部撞击。相较于钢板螺钉治疗肱骨干骨折,交锁髓内钉在治疗中具有手术时间较短、术中失血量较少、骨折愈合较快等优点,同时髓内钉本身也存在术后肩关节功能受限等并发症。
[Abstract]:Objective: to investigate the difference and effect of plate and screw internal fixation (plate internal fixation,PIF) and interlocking intramedullary nail (interlocking intramedu llary nail,IIN) in the treatment of humeral shaft fracture. Methods: from March 2013 to October 2014, the clinical data of 50 patients with humeral shaft fractures treated in orthopedic wards of affiliated Hospital of Shandong University of traditional Chinese Medicine (Eastern Hospital) were retrospectively analyzed. The samples were randomly divided into intramedullary treatment group (n = 22) and extramedullary treatment group (n = 28). The surgical treatment was performed with the corresponding internal fixation. Postoperative parameters included: operation time, intraoperative bleeding, fracture healing, postoperative complications. The data were analyzed by statistical software SPSS17.0. Results: 50 cases were collected and all cases were followed up. The average healing time of 22 patients with interlocking intramedullary nail fixation was 98.000 卤6.89 days. 2 the limited movement of shoulder joint was about 0-100 掳. The result of evaluation of curative effect was excellent in 16 cases, good in 4 cases, and excellent and good rate reached 90%. The average healing time was 106.142 卤6.29 days in 28 patients with internal fixation of steel plate. The results were excellent in 20 cases and good in 6 cases, reaching 92% excellent and good rate. Conclusion: this study shows that the treatment of humeral shaft fracture with intramedullary fixation and extramedullary fixation is effective. When using locking plate, we should avoid iatrogenic injury of radial nerve, and use interlocking intramedullary nail to bury the nail tail into the cortex of the great nodule and to protect the rotator sleeve from shoulder impact. Compared with plate and screw in the treatment of humeral shaft fracture, interlocking intramedullary nail has the advantages of shorter operative time, less intraoperative blood loss, and faster fracture healing. At the same time, intramedullary nail itself also has complications such as limited function of shoulder joint after operation.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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