锁定加压钛板与髓内钉治疗肱骨干骨折不愈合的临床疗效观察  

Observation on the clinical curative effect of locking compression plate and interlocking intramedullary nail fixation for treatment of humerus shaft fracture nonunion

作　　者：田培任 薛金伟[2] 戴富强 TIAN Pei-ren;XUE Jin-wei;Dai fu-Qiang(Department of Orthopaedics,The people's hospital of Jinzhou city Jinzhou 052260,China;The affiliated hospital of Hebei University,Baoding 071000,China;Department of orthopaedics,Heibei Fengfeng Group General Hospital,Handan 056000,China)

机构地区：[1]河北省晋州市人民医院骨科,河北晋州052260 [2]河北大学附属医院骨科,河北保定071000 [3]河北省峰峰集团总医院骨科院区,河北邯郸056000

出　　处：《吉林医学》2021年第2期299-301,共3页Jilin Medical Journal

摘　　要：目的:锁定加压钛板与髓内钉治疗肱骨干骨折不愈合的临床疗效观察。方法:对2012年1月~2018年7月收治的57例肱骨干骨折不愈合患者术前随机分为两组:锁定加压钛板内固定组(29例)和髓内钉内固定组(28例),术中均采用骨折端硬化骨切除、髓腔再通、并周围自体骨移植;术后指导相同的制动时间、功能康复锻炼。两组患者术前一般资料比较,差异均无统计学意义(P>0.05),具有可比性。比较手术时间、术后引流血量、疼痛愈合时间、肩肘关节功能(Constant-Murley)评分及并发症发生情况。结果:对57例肱骨干骨折不愈合患者行锁定加压钛板、髓内钉内固定植骨术并追踪随访12个月。两组患者术后骨折愈合时间、术后肘关节功能(Constant-Murley)评分比较,差异无统计学意义(P>0.05);两组手术时间比较,差异有统计学意义(P<0.05),锁定加压钛板切复内固定组明显小于髓内钉内固定组;两组间术后并发症发生率及肩关节功能(Constant-Murley)评分比较,差异有统计学意义(P<0.05)。结论:锁定加压钛板内固定植骨术治疗肱骨干骨折不愈合,手术时间短,术后并发症少,具有更明显的临床治疗效果。Objective Clinical observation of locking pressure titanium plate and intramedullary nail in the treatment of humeral shaft fracture nonunion.Method From January 2012 to July 2018,57 cases of the patients with nonunion of humeral shaft fractures were randomly divided into two groups before operation:locking pressure titanium plate to internal fixation group(29 cases)and intramedullary nailing to internal fixation group(28 cases).The sclerotic bone and medullary cavity recanalization were removed with a small incision at the fracture end,and surrounding autogenous bone transplantation was performed.There was no statistically significant difference in the preoperative general data between the two groups(P>0.05),and it was comparable to compare the shoulder and the elbow joint function(constant-murley)score and the incidence of complications of postoperative pain healing time.Results 57 cases of humeral shaft fractures with nonunion were treated with locking pressurized titanium plate,intramedullary nail internal fixation and bone grafting,and followed up for 12m.There was no significant difference in postoperative fracture healing time and postoperative shoulder、elbow joint function(constant-murley)score between the two groups(P>0.05).The difference in operation time between the two groups was statistically significant(P<0.05),and that of the locking plate cutting and internal fixation group was significantly lower than that of the intramedullary nail internal fixation group.There was a statistically significant difference in the incidence of postoperative complications between the two groups(P<0.05).Conclusion Locking and pressing titanium plate internal fixation and bone grafting in the treatment of humeral shaft fracture non-union,short operation time,fewer postoperative complications,has a more obvious clinical treatment effect.

关 键 词：肱骨干骨折 不愈合 肩关节功能 并发症 

分 类 号：R687.3[医药卫生—骨科学]