闭合复位、自锁髓内钉固定治疗肱骨干骨折疗效.docVIP

闭合复位、自锁髓内钉固定治疗肱骨干骨折疗效 　　[摘要] 目的 探讨采用闭合复位、自锁髓内钉固定治疗肱骨干骨折的临床疗效。 方法 应用闭合复位、自锁髓内钉固定治疗肱骨干骨折41例。 结果 术后随访5～18个月，骨折均愈合，平均愈合时间4.2个月。肩关节功能按Neer评分：优秀13例，满意27例，不满意1例；肘关节功能按HSS评价标准：优24例，良17例。 结论 闭合复位、自锁髓内钉固定治疗肱骨干骨折具有创伤小、出血少、固定可靠、可早期进行肩肘关节功能锻炼、取钉快捷安全等优点，疗效满意。 　　[关键词] 肱骨干骨折；髓内钉；内固定 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2012）04-0159-02 　　 　　Efficacy of closed reduction treatment for the humeral fracture with furcational self-locking intramedullary nail 　　HE Mingtang YANG Zejin ZHANG Weihong 　　Department of Geriatric Orthopaedics, Shenzhen Pingle Orthopaedic Hospital, Shenzhen 518010, China 　　[Abstract] Objective To study the clinical efficacy of closed reduction treatment for the humeral fracture with furcational self-locking intramedullary nail. Methods Fourty-one cases with the humeral fracture were treated with closed reduction and furcational self-locking inamedullary nails. Results All cases were followed up for 5 to 18 months and the bone fractures all healed. The average healing time was 4.2 months. According to the Neer’s scoring system of shoulder joint function, 13 cases were fine, 27 cases were good, 1 case was bad; According to the HSS evaluation criterion of elbow joint function, 24 cases were fine, 17 cases were good. Conclusion Closed reduction treatment of the humeral fracture with furcational self-locking intramedullary nail is less traumatic, has less hemorrhage and good firm fixation, and can do functional exercise with shoulder and elbow joint earlier, so it is an ideal method for correcting indications. 　　[Key words] Humeral fracture; Self-locking intramedullary nail; Inner fixation 　　 　　肱骨干骨折在临床上较常见，现多采用手术内固定治疗。我院2006年12月～2010年10月应用闭合复位、顺行插入自锁髓内钉固定治疗肱骨干骨折41例，疗效满意，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　本组41例，男28例，女13例；年龄21～63岁，平均43.1岁。受伤原因：交通事故伤16例，摔伤11例，高处坠落伤8例，重物砸伤6例。均为新鲜闭合性骨折。合并有原发性桡神经损伤2例。骨折部位：肱骨中上1/3段12例，中1/3段24例，中下1/3段5例。骨折按AO分型：A型24例，B型13例，C型4例。受伤至手术时间1～9 d。 　　1.2 手术方法 　　臂丛神经阻滞麻醉，仰卧位，置肩关节中立位，取前方肩峰下入路，于肱骨大结节顶端内侧与肱骨头关节面边缘之间处骨锥打开髓腔，闭合使骨折处复位，按照