外固定支架能否成为治疗肱骨干骨折的理想选择?  

Could external fixator become the ideal choice for the treatment of humeral shaft fracture?

作　　者：艾进伟[1] 韩叶萍[1] 李沛[1] 曹玉净[1] 张建福[1] 

机构地区：[1]河南中医学院第二附属医院骨科,河南省郑州市450002

出　　处：《中国组织工程研究》2013年第17期3208-3215,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:肱骨干骨折的治疗存在很多争议,桡神经损伤和骨折不愈合的发生率还很高,如何治疗复杂的肱骨干骨折是医生头痛的问题。目的:综合分析外固定支架治疗肱骨干骨折的可靠性。方法:利用外固定支架治疗肱骨干骨折患者10例。骨折均为外伤导致的闭合骨折,按AO分型:A型2例,B型骨折3例,C型骨折5例。采用麻醉下闭合复位或骨折端小切口复位,单纯外固定支架固定。治疗后1,4,8,12,20,24周和1年拍肱骨正侧位X射线片,观察骨折对位及骨折愈合情况,采用Constant评分及Mayo评分评估肩、肘关节功能。结果与结论:随访12个月10例患者骨折均骨性愈合,愈合时间为外固定支架治疗后12-24周,平均16.1周愈合。1例出现桡神经损伤症状,于治疗后12周神经功能完全恢复。患者肩关节Constant评分平均为77.3分;肘关节功能恢复良好,Mayo评分平均为81.8分。结果证实,外固定支架治疗各型肱骨干骨折能取得较好的治疗效果。BACKGROUND：The treatment of humeral fractures remains many disputes, the incidence of radial nerve damage and fracture nonunion is stil high, so how to treat complex humeral fracture is a headache problem for doctors. OBJECTIVE：To explore the reliability of external fixator for the treatment of humeral shaft fractures. METHODS：Ten cases of humeral shaft fractures were treated by external fixator. And the fractures were al closed and caused by trauma. According to the AO classification, there were two cases of type A, three cases of type B and five cases of type C. Under anesthesia, the patients were treated with closed reduction or smal incision reduction, and were fixed by external fixation. The anteroposterior X-ray films of humerus were taken at 1, 4, 8, 12, 20 and 24 weeks and 1 year after treatment for the observation of fracture alignment and fracture healing. The shoulder and elbow joint function was evaluated with Constant score and Mayo score. RESULTS AND CONCLUSION：Al patients were fol owed-up for 12 months. Al the fractures were healed and the average healing time was 16.1 weeks （ranged from 12-24 weeks after external fixation）. Radial nerve injury symptoms occurred in one case and completely recovered after 12 weeks after the operation. The Constant score of the shoulder joint function was 77.3;the elbow joint function recovered wel with the Mayo score of 81.8. External fixator is the ideal choice for various humeral shaft fractures.

关 键 词：骨关节植入物 骨与关节临床实贱 肱骨干 骨折 外固定支架 外固定 肩关节 肘关节 Constant评分 Mayo评分 骨折愈合 X射线 

分 类 号：R318[医药卫生—生物医学工程]