肱骨干骨折三种内固定方法的比较.docVIP

肱骨干骨折三种内固定方法的比较 　　【摘要】 目的 比较三种内固定方法治疗肱骨干骨折的疗效，探讨肱骨干骨折最佳的内固定方法。方法 肱骨干骨折89例，骨折复位后，分别采用“8”字钢丝联合克氏针 (实验组)，加压钢板(DCP组)，交锁髓内钉(LIN组)内固定，比较三种方法的治疗效果。结果 三组患者均在治疗6个月后达骨性愈合，且肩肘关节无明显受限，加压钢板，交锁髓内钉内固定畸形愈合率较高，而“8”字钢丝加克氏针内固定全部获解剖愈合。全部病例均获随访，时间9～24个月，实验组骨折愈合时间短于DCP组和LIN组（P＜0.05）。结论 “8”字钢丝联合克氏针内固定、加压钢板及交锁髓内钉对于治疗肱骨干骨折均能提供稳定的内固定并愈合，但“8”字钢丝联合克氏针内固定对于减少手术并发症更具有优势。 　　?ぁ竟丶?词】 肱骨干骨折；“8”字钢丝；克氏针；加压钢板；交锁髓内钉；骨折内固定?? 　　文章编号：1003-1383(2008)05-0530-03中图分类号：R 683.41文献标识码：A?? 　　 　　Comparison of three internal fixation of humeral shaft fractures 　　LI Wenzhong?? 　　(Department of Orthopaedics，The Traditional Chinese Medicine Hospital of Qiannan autonomous 　　??prefecture for Buyi and Miao Nationalities，Duyun,Guizhou558000,China)?お? 　　【Abstract】 Objective To compare the therapeutic effects of three internal fixation for humeral shaft fractures. 　　Methods There were 89 cases of humeral shaft fracture. After replacement ,8steel string withkirschner pin, Dynamic compressive plate(DCP),locked intramedullary nail(LIN) were selected for internal fixation.Results Osseous healing was achieved in all cases after 6 months of treatment and the shoulder function was not limited. Dynamic compressive plate and lockedintramedullary nail for internal fixation could achieve higherpercentage of malunion but 8steel string withkirschner pin could achieveanatomic healing. All patients were followed up for 9 ～24 months .The fracturehealing time of8steel string withkirschner pin groups were shorter than that of DCP and LIN groups（P＜0.05）。Conclusion For patients who need surgical treatment of a humeral shaft fracture, 8steel string withkirschner pin and dynamic compressive plate and intramedullary nail provide predictable resuits for achieving fracture stabilization and ultimate healing,but 8steel string withkirschner pin has fewer complications. 　　?ぁ?Key words】 humeral shaft fracture； 8steel string； kirschner pin；dynamic compressive plate；lockedintramedullary nail；internal fixation?? 　　 　　肱骨干由于其生理原因，上臂承受外展、旋转、重力的负荷