单边外固定器在肱骨干下1/3骨折治疗中的应用  

The use of unilateral external fixators in treatment of distal shaft fractures of humerus

作　　者：李振宙 侯树勋 张伟佳 李文峰 商卫林 吴闻文 

机构地区：[1]解放军三四医院骨科,北京市100037

出　　处：《中华创伤骨科杂志》2004年第2期148-150,157,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的回顾分析单边外固定器治疗肱骨干下1/3骨折的效果。方法1997年10月～2002年10月33例肱骨干下1/3骨折,年龄18～70岁(平均31岁),其中横形骨折3例、斜形骨折1例、螺旋形骨折9例、粉碎性骨折20例。15例行切开复位、有限内固定结合外固定器固定,10例行切开复位、外固定器固定,8例行闭合复位、外固定器固定。9例桡神经损伤者均行桡神经探查。结果随访8～24个月(平均18个月)。骨折愈合时间11～22周,平均14周。术后有2例桡神经损伤,与术前的9例桡神经损伤在最后一次随访时均恢复功能。肘关节功能恢复正常。有7例外固定针孔感染,经口服抗生素及针道清创后好转。结论单边外固定器结合切开复位、有限内固定,在肱骨干下1/3骨折治疗中具有独特的价值及良好的效果。Objective To retrospectively analyze the results of unilater al external fixators in the treatment of the distal third fractures of humeral s hafts. Methods From October 1997 to October 2002, 33 patients from 15y-70y (ave rage 31y) with the distal third fractures of humeral shafts were treated with un ilateral external fixators. They included 3 transverses fractures, 1 oblique fra cture, 9 spiral fractures and 20 comminuted fractures. 15 cases were treated wit h open reduction and fixation with external fixators and limited internal fixati on, 10 cases were treated with open reduction and fixation with external fixator s, and 9 cases were treated with closed reduction and fixation with external fix ators. 9 cases with radial nerve injury undewent nerve exploration. External fix ators were removed after bone healing. Duration of follow-up was 8 to 24 m (ave rage 18 m). Results The time of bone healing was 11 to 22 w (average 14 w). At t he latest follow-up, the function of injured radial nerves in 9 preoperative ca ses and 2 postoperative cases and the motion function of elbow were restored to normal. There were only 7 cases of superficial pin site infection which were cur ed with oral antibiotics and pin site care with mild disinfectants. Conclusion U nilateral external fixators can play special roles and have good results in the treatment of the distal third fractures of humeral shafts, combined with open re duction and limited internal fixation.

关 键 词：单边外固定器 肱骨干骨折 神经损伤 骨折愈合 手术方法 解剖结构 

分 类 号：R687.3[医药卫生—骨科学]