可膨胀自锁髓内钉治疗肱骨中1/3骨折  

Treatment of 1/3 midsharft humeral fracture using inflatable self-locking intramedullary nailing system

作　　者：沙勇[1] 丁晶[1] 李春晓[1] 徐永清[1] 李军[1] 李福兵[1] 

机构地区：[1]成都军区昆明总医院骨科全军创伤骨科研究所,云南昆明650032

出　　处：《临床骨科杂志》2012年第6期640-642,共3页Journal of Clinical Orthopaedics

基　　金：云南省应用基础研究项目(编号:2011FZ312)

摘　　要：目的探讨可膨胀自锁髓内钉治疗肱骨干中1/3骨折的临床疗效。方法应用可膨胀自锁髓内钉治疗18例肱骨中1/3骨折患者。结果 10例闭合复位,手术时间40～60 min,术中出血量40～150 ml;8例切开复位,手术时间60～100 min,术中出血量50～150 ml。18例均获随访,时间3～5年。患者骨折均获得临床骨性愈合,愈合时间12～18周。肩关节功能根据Neer评分:优13例,良4例,可1例。无神经血管损伤、感染、脂肪栓塞及髓内钉松动等并发症。2例出现进钉点处压痛,取出内固定后疼痛消失。结论可膨胀自锁髓内钉内固定治疗肱骨干中1/3骨折,操作简便,固定牢靠,创伤小,可早期行上肢康复训练,患肢功能恢复好,并发症少。Objective To study the clinical efficacy of the inflatable self-locking intramedullary nailing in treatment of the middle 1/3 of humeral shaft fracture. Methods Expandable self-locking intramedullary nail was used for the treatment of middle 1/3 humeral fracture in 18 cases. Results 10 cases underwent closed reduction, and the opera- tion time was 40 ～ 60 min,intraoperative blood loss was 40 ～ 150 ml; 8 cases underwent open reduction surgery for 60 ～ 100 min, and intraoperative blood loss was 50 ～ 150 ml. 18 patients were followed up for 3 ～ 5 years. 18 pa- tients got clinical bone healing in 12 ～ 18 weeks. Shoulder function according to the Neer score were excellent in 13 cases, good in 4, and fair in 1 case. There were no neurovascular injury, infection, fat embolism, no case of nonun- ion, fixation loose in 18 cases postoperatively. 2 cases were found the needle point tenderness, and pain disappeared alter removing the fixation. Conclusions Placement and removal of expandable self-locking intramedullary nail fixa- tion in the treatment of middle 1/3 humeral shaft fracture are simple, and the fixation is stable with minimal trauma in surgery, and early upper limb rehabilitation training makes good limb function recovery with fewer complications.

关 键 词：可膨胀自锁髓内钉 肱骨骨折 骨折固定术 髓内 

分 类 号：R683.41[医药卫生—骨科学] R687.33[医药卫生—外科学]