钛制弹性髓内钉内固定治疗肱骨近端骨折的初步观察  

Intramedullary osteosynthesis of proximal humeral fractures with titanium elastic nails: a preliminary report

作　　者：孙晋客[1] 王英振[1] 刘晓静[2] 王年芳[2] 

机构地区：[1]青岛大学医学院附属医院关节外科,山东省青岛市266003 [2]山东省文登整骨医院骨伤研究所

出　　处：《中国骨与关节损伤杂志》2014年第7期688-690,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 探讨钛制弹性髓内钉内固定治疗成人不稳定肱骨近端骨折的可行性及疗效。方法 回顾性分析自2009-06-2012-12采用钛制弹性髓内钉内固定治疗的42例成人肱骨近端骨折的临床资料。结果 本组42例平均随访17.2个月（10-30个月）。平均手术时间28 min（20-60 min）,平均出血量45 ml（20-100 ml）。骨折均获愈合,平均愈合时间为8.8周（6-12周）。末次随访时,VAS疼痛评分平均0.7分（0-4分）;Constant-Murley绝对值评分平均86.7分（68-100分）,优17例,良20例,可4例,差1例,优良率88.1%。未发生神经血管损伤、感染、骨折不愈合及肱骨头坏死等并发症。结论采用钛制弹性髓内钉内固定治疗成人肱骨近端骨折效果良好,具有创伤轻微、固定可靠、并发症少等优点,适用于肱骨外科颈骨折以及部分合并大结节骨折的3部分骨折。Objective To explore the feasibility and the clinical outcome of intramedullary osteosynthesls of displacedproximal humeral fractures with titanium elastic nails. Methods From June 2009 to December 2012, 42 patients withdisplaced fractures of proximal humerus were treated with intramedullary osteosynthesis by titanium elastic nails andretrospective analyzed. Results All patients were followed-up with the mean time of 17.2 months （range 10-30 months）. Themean operating time was 28 min （range 20-60 rain）, and the mean blood losses were 45 ml （range 20-100 ml）. All fractureswere healed with an average of 8.8 weeks（range 6-12 weeks）. At last follow-up, the mean VAS score was 0.7 points（range 0-4points）. The mean absolute Constant-Murley score was 86.7 points （range 68-100 points） with excellent in 17 cases, good in20, fair in 4 and bad in 1, and the excellent and the good rate was 88.1%. There were no vessel and nerve deficits, infection,nonunion and avascular necrosis of the humeral head. Conclusion Intramedullary osteosynthesis of proximal humeralfractures with titanium elastic nails can lead to good clinical outcome with minimal invasion and less complications.

关 键 词：肱骨骨折 钛制弹性髓内钉 闭合复位 内固定 

分 类 号：R683.41[医药卫生—骨科学]