肱骨中段骨折伴有桡神经损伤的手术探查  

Injury of radial nerve in humeral fractures

作　　者：孟祥龙[1] 王庆一[1] 曲铁兵[1] 王进军[1] 关立[1] 

机构地区：[1]首都医科大学附属北京朝阳医院骨科,100020

出　　处：《中国现代医药杂志》2005年第3期45-47,共3页Modern Medicine Journal of China

摘　　要：目的探讨肱骨中段骨折伴有桡神经损伤情况.方法对本院1998～2003年收治的164例肱骨干中段骨折病人进行回顾性研究,分析桡神经在各种骨折类型中的损伤及恢复情况,并应用SPSS 11.0对结果进行分析.结果34.0%粉碎性骨折病人,25.0%螺旋型骨折病人,6.98%横行骨折病人出现桡神经损伤,术中探查见除3例粉碎性骨折出现桡神经部分损伤和横断伤之外,其他病人没有明显的桡神经损伤.13例急诊手术的完全性桡神经损伤病人虎口区感觉恢复时间平均为7.9周,肱桡肌和桡侧腕伸肌肌力恢复在伤后9周,完全恢复时间为3.4个月,12例非急诊手术的完全桡神经损伤的病人虎口感觉恢复在伤后9.8周,肱桡肌和桡侧腕伸肌肌力的恢复在伤后12周,完全恢复时间为4.5个月.结论高能量损伤、粉碎性肱骨中段骨折的病人桡神经损伤的可能性大,对于伴有桡神经损伤的肱骨中段骨折病人早期探查桡神经,神经恢复早,闭合复位要注意桡神经卡压损伤的可能.Objective To study the radial nerve injures in humeral fractures. Methods 164 patients with radial nerve injury in middle part of fractured humeral were studied retrospectively. Studied the mechanism of injury, relations between classification of fractures and nerve entrapment, and degrees of injury energy. Results 34.0% patients of communicated fractures, 25.0% of spiral fractures and 6.98% of transverse fractures presented the injuries of radial nerve, and broken epineuriums were found in two patients of comminute fractures and a transverse ruptured radial nerve also found in a comminuted facture at surgery. Conclusion High energy and communicated fracture increase the possibility of radial nerve injure. The earlier exploration is done, the earlier recovery can be obtained. And operators should pay much attention to the radial nerve when closed reduction is processed.

关 键 词：桡神经损伤 肱骨骨折 肱骨中段骨折 手术探查 粉碎性骨折 骨折病人 恢复时间 急诊手术 肌力恢复 高能量损伤 

分 类 号：R687[医药卫生—骨科学]