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1.
单侧外固定架治疗复杂性肱骨下段骨折 总被引:1,自引:0,他引:1
目的 :探讨复杂性肱骨下段骨折的治疗方法。方法 :采用 Bastiani式单侧外固定架治疗 16例。开放性骨折立即外固定 ;闭合性骨折小切口复位外固定 ,骨折极度不稳加有限内固定 ;骨折感染、畸形及延迟愈合分别行病灶清除闭合冲洗、截骨矫形及加压外固定。结果 :术后随访 6个月~ 1.5年 ,除 1例外固定架松动骨折移位再次手术治愈外 ,余 15例骨折平均 3.6 (2 .5~ 5 .5月 )个月愈合。 2例肩、肘关节僵硬经手法松解、自主锻炼功能恢复。结论 :该外固定架操作简便、固定可靠、有利于骨与软组织修复 ,可有效治疗复杂性肱骨下段骨折。 相似文献
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[目的]探讨三维外固定架结合有限内固定治疗肱骨干粉碎性骨折的临床疗效。[方法]2000年1月-2006年5月,收治肱骨干粉碎性骨折28例,骨折根据AO/ASIF分类,其中:B1型5例,B2型3例,B3型9例,C1型6例,C2型4例,C3型1例,采用三维外固定架结合螺钉和/或钢丝有限内固定治疗,术后3d行合理的康复治疗。从手术情况、并发症、骨折愈合及功能评价等方面对疗效进行分析。[结果]28例患者术后获平均13(10—15)个月随访,27例患者获骨性愈合,愈合率96.4%,骨折愈合时间12—33周,平均19.5周。除1例骨折未愈合外,余肩、肘关节功能均正常,优良率92.8%。[结论]三维外固定架结合有限内固定是治疗肱骨干粉碎性骨折的较好方法,符合骨折治疗的微创生物学原则,操作简单,固定可靠,功能恢复满意。 相似文献
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目的探讨组合式外固定架治疗肱骨干粉碎性骨折的方法、适应证、治疗效果,以及与传统方法的比较。方法闭合性骨折首先在臂丛神经阻滞麻醉下手法整复骨折,分别在肱骨近端和肱骨髁上后外侧拧入螺纹钉,固定连接杆;开放性骨折先清创复位,置入螺纹钉,缝合伤口,放置引流,再固定连接杆。结果23例获得6~61个月随访;骨折愈合时间平均3.4个月;外固定架使用时间平均4个月;2例发生钉道反应,1例发生骨折延迟愈合;12例肘关节功能完全康复,9例肘关节功能受限<25°,2例肘关节功能受限在25°~40°。结论组合式外固定架治疗肱骨干粉碎性骨折具有创伤小、固定牢、骨折愈合快、关节锻炼早、并发症少等优点,很有应用价值。 相似文献
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[目的]比较外固定架与钢板内固定治疗肱骨投弹骨折的临床疗效。[方法]回顾性分析2016年1月—2020年1月60例肱骨投弹骨折患者的临床资料,依据医患沟通结果,30例采用外固定架固定,必要时增加小切口拉力螺钉固定(外固定组),30例采用钢板内固定(内固定组)。比较两组术前一般资料、围手术期情况、随访结果和影像资料。[结果]术中桡神经损伤外固定组为1例,内固定组为6例,差异有统计学意义(P<0.05)。外固定组切口长度和术中出血量显著优于内固定组(P<0.05)。两组患者随访(14.23±1.89)个月。外固定组术后开始主动活动时间和完全负重活动时间显著早于内固定组(P<0.05)。随术后时间推移,两组肘伸屈ROM、肩上举ROM及MEPS、Constant-Murley评分均逐渐增加,且外固定组肘伸屈ROM及MEPS评分优于内固定组,差异均有统计学意义(P<0.05),但两组间肩上举ROM及Constant-Murley评分差异无统计学意义(P>0.05)。影像显示两组骨折复位质量的差异无统计学意义(P>0.05)。但外固定组骨折愈合时间显著早于内固定... 相似文献
5.
我们自2002年3月~2005年9月采用有限内固定结合单臂外固定架方法急诊治疗肱骨干中远端C型骨折23例,取得满意效果。资料与方法一、一般资料本组23患,男15例,女8例;年龄17~68岁,平均32岁。致伤原因:交通伤20例,摔伤3例。X线片证实为肱骨远端粉碎性骨折。骨折根据AO/ASIF分型:C1型14例,C2型5例, C3型4例。闭合性骨折20例,开放性骨折3例(Gustilo分类均 相似文献
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肱骨干骨折手术治疗方法包括钢板内固定、外固定架以及髓内钉固定等。由于上臂独特的生物力学特点,术后出现骨折不愈合的比例较多。我院近几年应用外固定架治疗肱骨干骨折,并配合中药三期辨证施治,取得了满意的疗效。 相似文献
8.
单侧外固定架治疗股骨干骨折 总被引:3,自引:0,他引:3
目的 :探讨外固定架治疗股骨干骨折的适应证和疗效。方法 :回顾性分析了 1996年 1月~ 2 0 0 1年 1月用外固定架治疗的股骨干骨折 5 6例 ,其中新鲜骨折 4 9例 ,陈旧骨折 7例。骨折粉碎程度按 Winquist分度 :0°11例 , °12例 , °15例 , °10例 , °8例。结果 :全部骨折都在 6个月内愈合 ,取掉外固定架。取架后 3个月复查 ,用改良 Thoeresen标准评定结果 :优 39例、良 14例、可 3例 ,优良率 94 .5 %。结论 :外固定架治疗股骨干骨折的最佳适应证是 °、 °开放性骨折 ,伴有感染的骨折 ,感染骨不连接 ,股骨干骨折合并血管损伤 ,儿童股骨干骨折 ,股骨干合并股骨颈骨折 相似文献
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我们自 1 997年 7月以来 ,采用单侧多功能外固定架治疗儿童下肢骨折 35例 ,效果理想 ,现报告如下。1 临床资料 自 1 997年 7月以来 ,我们选择 35例病人 ,男 2 4例 ,女 1 1例 ;年龄 5~ 1 4岁 ,平均 9 7岁。 2 9例为新鲜骨折 ,6例骨不愈合。其中股骨干骨折 2 1例 (骨不愈合 4例 ,开放性 1 3例 ,闭合性 4例 ) ,胫腓骨骨折 1 4例 (骨不愈合 2例 ,开放性 9例 ,闭合性 3例 )。 2 9例新鲜骨折中 1 3例合并其它损伤 ,其中脑外伤 8例 ,脾破裂 3例 ,椎体骨折和肋骨骨折各 1例。在 2 2例开放性骨折中有不同程度的软组织挫裂伤 (Ⅰ度 7例 ,Ⅱ度1 2… 相似文献
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Lowerthirdhumeralshaftfracturesareoftenmanifestedbyoblique,spiralorcomminutedfractureswithahighincidenceofcomplicatingradialnerveinjury.Thispartofhumerusisirregularanatomicallyandneartheelbowjoint.Soitisdifficult toselectproperinternalfixationinstrumentswhile exploringradialnervethroughanterolateralapproach,whichaddsdifficultyinthetreatmentofthiskindof fractures.Inrecent6yearsweusedunilateralexternal fixatorstotreatsuchkindoffracturesinourdepartment andsatisfactoryresultswereachieved.METHOD… 相似文献
13.
目的:探讨外固定器加小夹板外固定治疗肱骨干骨折的疗效。方法:以单臂外固定器加小夹板外固定治疗肱骨干斜形、螺旋形、粉碎性及多节骨折36例。其中,男25例,女11例;年龄为14~82岁,平均34·4岁。按AO/ASIF分类:A2型11例,B型19例,C型6例。观察骨折临床愈合时间及手术后并发症。以“Constant肩关节评分法”评价肩关节功能,以“关节活动范围测量”评价肘关节功能。结果:随访7~15个月,平均9·3个月。所有骨折均达功能复位或解剖复位,术后平均12周(9~25周)达临床愈合。术后平均7周(4~13周)拆除小夹板,术后平均12周(9~25周)拆除外固定器。最后随访时Constant肩关节评分平均为96分(89~100分),而肘关节功能不受影响。无并发症发生。结论:该疗法用于治疗不稳定性肱骨干骨折具有简便易行、创伤少、固定牢、费用低等优点。两种固定方法同时使用可以取长补短,提高疗效,值得推广。 相似文献
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目的:探讨外固定器加小夹板外固定治疗肱骨干骨折的疗效。方法:以单臂外固定器加小夹板外固定治疗肱骨干斜形、螺旋形、粉碎性及多节骨折36例。其中,男25例,女11例;年龄为1482岁,平均34·4岁。按AO/ASIF分类:A2型11例,B型19例,C型6例。观察骨折临床愈合时间及手术后并发症。以“Constant肩关节评分法”评价肩关节功能,以“关节活动范围测量”评价肘关节功能。结果:随访715个月,平均9·3个月。所有骨折均达功能复位或解剖复位,术后平均12周(925周)达临床愈合。术后平均7周(413周)拆除小夹板,术后平均12周(925周)拆除外固定器。最后随访时Constant肩关节评分平均为96分(89100分),而肘关节功能不受影响。无并发症发生。结论:该疗法用于治疗不稳定性肱骨干骨折具有简便易行、创伤少、固定牢、费用低等优点。两种固定方法同时使用可以取长补短,提高疗效,值得推广。 相似文献
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Carroll EA Schweppe M Langfitt M Miller AN Halvorson JJ 《The Journal of the American Academy of Orthopaedic Surgeons》2012,20(7):423-433
Humeral shaft fractures account for approximately 3% of all fractures. Nonsurgical management of humeral shaft fractures with functional bracing gained popularity in the 1970s, and this method is arguably the standard of care for these fractures. Still, surgical management is indicated in certain situations, including polytraumatic injuries, open fractures, vascular injury, ipsilateral articular fractures, floating elbow injuries, and fractures that fail nonsurgical management. Surgical options include external fixation, open reduction and internal fixation, minimally invasive percutaneous osteosynthesis, and antegrade or retrograde intramedullary nailing. Each of these techniques has advantages and disadvantages, and the rate of fracture union may vary based on the technique used. A relatively high incidence of radial nerve injury has been associated with surgical management of humeral shaft fractures. However, good surgical outcomes can be achieved with proper patient selection. 相似文献
16.
A. Mølster Nils R. Gjerdet Rolf M. Strand Randi M. Hole Leiv M. Hove 《Archives of orthopaedic and trauma surgery》2001,121(10):554-556
The aim of this in vitro study was to compare the mechanical behavior of fixation by the Russell-Taylor nail with the more
recent Polarus nail. Fixation with an experimental nail made from polyacetal polymer was also included in the study. Thirty
humeri were fractured and randomized to receive one of the three nail types. A four-point nondestructive bending test was
performed, as well as torsional testing to failure. The torsional test was designed to record the amount of ‘play’ (uncontrolled
rotation) in the bone/implant construct. The Polarus nail gave higher rigidity of the nail/bone construct than the two other
types. The Russell-Taylor nailing exhibited a high degree of ‘play’ (uncontrolled rotation). The polyacetal nails allowed
a large elastic deformation before failure.
Received: 5 December 2000 相似文献
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Twenty-nine patients with non-union of the humeral shaft, who were treated in 3 major Vancouver hospitals, were studied. Reasons for non-union, effectiveness of various treatment methods, and complications are discussed. Fractures occurring in the middle third of the humeral shaft, comminuted or open fractures and those treated early by open reduction, are more prone to non-union. Nearly 50 per cent of the patients with non-union were chronic alcoholics. Compression plating with cancellous bone grafting gave the best rate of healing. However, both early and late operative treatment gave a relatively high complication rate. 相似文献
18.
Interlocking nailing of humeral shaft fractures 总被引:2,自引:0,他引:2
N. O. B. Thomsen J. B. Mikkelsen R. N. Svendsen N. Skovgaard C. H. Jensen U. Jørgensen 《Journal of orthopaedic science》1998,3(4):199-203
In this retrospective study 48 humeral shaft fractures in 48 patients were operated on using the Seidel interlocking nail.
The length of follow-up ranged from 6 to 60 months (median, 26 months). The treatment of fractures was satisfactory with the
Seidel nail, but we emphasize the importance of countersinking the tip of the nail into the humeral head to avoid impingement.
In 5 of 12 patients with non-unions, the procedure failed, and we found that the distal locking seemed to be inadequate. Pathological
fractures (i.e., those caused by metastatic tumors) were all efficiently treated with the Seidel nail.
Received for publication on Sept. 30, 1997; accepted on Feb. 2, 1998 相似文献
19.
Intramedullary nailing of humeral shaft fractures 总被引:5,自引:1,他引:5
From 1996 until 2000 we treated 52 humeral shaft fractures with AO unreamed nailing. Mean patient age was 35.8 years and the average follow-up 29.6 months. There were 31 type A fractures, 15 type B, and 6 type C. Closed retrograde nailing was performed in 46 cases and open nailing in six. Functional results were excellent in 48 cases, moderate in three, and poor in one. 相似文献
20.
Summary
Humeral shaft fractures can be treated either conservatively or operatively. Plating of the humerus is the established operative
method, but recently interest has also been focussed on intramedullary nailing. Fifty-nine cases of humeral fractures treated
with intramedullary nailing (Seidel/Marchetti-Vicenzi/Prévot) from January 1991 to December 1995 (44 fractures after trauma,
11 pathological fractures, 3 pseudarthroses, 1 re-fracture). Closed reduction in 55/59 cases. One infection (soft tissue);
2/48 pseudarthrosis (indication for nailing: pseudarthrosis!). No iatrogenic palsy of the radial nerve. Functional postoperative
treatment in all 44 cases of humeral fractures after adequate trauma. One poor functional result: periarticular ossification
after retrograde nailing, possibly connected with long-term respiratory treatment after trauma. Treatment of humeral shaft
fractures by intramedullary nailing is favoured in our clinic (low complication rates, excellent or good functional results,
limited approaches, small scars). Proximal fractures should be treated by the Seidel nail (stable interlocking of the proximal
fragment); very distal fractures need Prévot nailing (reaming of condylar canals). All other fractures of the humeral shaft
can be treated by each of the implants used in our clinic. Pathological fractures are an excellent indication for intramedullary
stabilization. These patients benefit from stable fixation without intense surgical trauma. Pseudarthrosis, according to our
limited experience, seems to require plating plus bone grafting. Plating is also recommended if revision of the radial nerve
becomes necessary.
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