肱骨干骨折涉及或合并肱骨近端骨折的髓内针治疗  

Intramedullary nail treatment of humeral shaft fracture combined/extended proximal humeral fracture

作　　者：黄强[1] 刘兴华[1] 郭祁[1] 蒋协远[1] 

机构地区：[1]北京积水潭医院创伤骨科,北京100035

出　　处：《中国医刊》2013年第4期25-28,共4页Chinese Journal of Medicine

摘　　要：目的总结肱骨干骨折涉及或合并肱骨近端骨折时，采用髓内针治疗的效果。方法采用髓内针治疗肱骨干骨折涉及或合并肱骨近端骨折19例，手术均采用闭合复位，近端锁定的髓内针固定。其中14例获得随访，随访9～38个月，平均23．5个月。复查时拍片判断骨折愈合情况，采用Constant．Merley绝对值评分方法评价术后疗效。结果14例新鲜骨折均顺利愈合，平均愈合时间14．2周（10～20周），平均Con．stant—Merley绝对值86．8分（76—98分），平均前屈上举148．5°，其中优良11例，可3例。结论髓内针是治疗涉及或合并肱骨近端骨折的肱骨干骨折可选的方法之一。Objective Summarize the methods and the results of the operative treatment of humeral shaft fracture combined/extended proximal humeral fracture with intramedullary nail. Method From Aug 2007 to Dee 2010, we treated the complicated fracture 19 cases in our department, 14 cases have the full flow-up. The mean follow up time is 23.5 months（9 - 38 months）. All the fracture were treated with closed reduction and internal fixation with intr- amedullary nail with proximal locking screw of Trigen nail. Taking X-ray to judge the bone healing. Using the abso- lute Constant-Murley rating system. Result All the 14 patients healing uneventfully. Average healing time is 14.2 weeks（ 10-- 20 weeks）. The average absolute Constant-Murley score is 86.8 （76 -98）, 11 cases are excellent and good,3 cases are fair. The average forward elevation is 148.5°. Conclusion For the humeral shaft fracture com- bined/extended proximal humeral, closed reduction and internal fixation with intramedular nail is advisable.

关 键 词：骨折 肱骨干骨折 肱骨近端骨折 髓内针 

分 类 号：R683.4[医药卫生—骨科学]