Acumed前臂髓内钉治疗成人前臂双骨折

目的 :探讨Acumed前臂髓内钉治疗成人前臂双骨折的临床疗效。方法:2009年1月至2016年12月采用Acumed髓内钉治疗成人前臂双骨折患者86例,男54例(62.8%),女32例(37.2%),年龄18~72岁,平均36.8岁;右侧50例,左侧36例。记录病例手术时间、术中出血量、放射暴露时间、骨折愈合时间、并发症,DASH问卷调查(Disabilities of the Arm,Shoulder and Hand questionnaire)和Grace-Eversman疗效评级以评估髓内钉治疗前臂骨折的临床效果。结果:86例患者均获随访,随访时间48~144周,平均86.8周;术中出血量30~80 ml,平均52 ml;放射性暴露时间1~6 min,平均2.5 min;手术时间31~55 min,平均46 min。85例骨折顺利愈合,愈合时间10~16周,平均13.3周。3例患者出现并发症,其中1例肥大性骨不连,1例尺桡骨间骨桥形成,1例拇长伸肌腱损伤。DASH评分0~28分,平均15.6分;Grace-Eversman评价结果,优65例,良15例,可5例,差1例。结论:前臂髓内钉用于治疗成人前臂双骨折具有微创、手术时间短、并发症少等优点,临床效果满意。

Acumed intramedullary nail for the treatment of adult diaphyseal both-bone forearm fractures

Objective: To evaluate the results of Acumed intramedullary nail for the treatment of adult diaphyseal fractures of both-bone forearm fractures.Methods: From January 2009 to December 2016,86 adult patients with both forearm fractures were treated by intramedullary nail including 54 males and 32 females with an average age of 36.8 years old ranging from 18 to 72 years old;There were 50 cases were on the right and 36 cases on the left. The operation time,blood loss and X-ray expose time intra-operation,time of fracture union,complications,DASH(Disabilities of the Arm,Shoulder and Hand questionnaire),Grace-Eversman criteria were recorded to evaluate the clinical outcomes of intramedullary nail for the treatment of forearm fractures.Results: All patients were followed up from 48 to 144 weeks with an average of 86.8 weeks;the blood loss intraoperation was 30 to 80 ml with an average of 52 ml;the the X-ray expose time was 1 to 6 min with an average of 2.5 min;the operation time was 31 to 55 min with an average of 46 min;Among them,85 cases healed successfully,the union time was 10 to 16 weeks with an average of 13.3 weeks. There were 1 case of hypertrophic nonunion,1 case of ulnar radial bone bridge formation,and 1 case of extensor hallucis longus tendon injury. The DASH score was 4 to 37(means 15.6);according to Grace-Eversman criteria,the results were excellent in 65 cases,good in 15,acceptable in 5,poor in 1.Conclusion: Intramedullary fixation method in treating both-bone forearm fractures has advantages of closed application,short operation time,little complication,and clinical outcomes is satisfied.