旋入式自锁钉与常规手术治疗肱骨干骨折疗效比较及相关问题探讨

目的]报告旋入式自锁钉与常规手术治疗肱骨干骨折的临床效果,寻找治疗肱骨干骨折的最佳手术固定方法.方法]回顾性分析2000年3月～2004年5月手术治疗各型肱骨干骨折135例,其中常规手术组96例,包括应用加压钢板42例、单边外支架26例、形状记忆合金环抱器28例;旋入式自锁钉组39例,对手术和术后的各项指标进行比较.结果]常规手术组手术时间和失血量明显多于旋入式自锁钉组,医源性桡神经损伤、感染、断钉断板或钉板松动、骨折再移位、骨不连等并发症明显多于旋入式自锁钉组,术后满意率明显低于旋入式自锁钉组.结论]旋入式自锁钉克服了交锁钉横向锁钉的种种弊端,手术操作简便,创伤性小,固定可靠,有顺行和逆行穿针2种选择,减少了对肩关节功能的影响,常规手术方法存在较多的不足,应根据骨折部位和类型选择应用.

Study on clinical effect and interrelated questions of revolving self-lock nails and normal operative therapy for humerus shall fracture

Objective]To summarize the clinical effect of revolving self-lock nails and normal operative therapy for humerus shaft fracture,and discuss the perfect treatment methods.Method]We retrospectively analyzed and compared the outcome and complications of the the humerus shall fracture by normal operative therapy in 96 cases(compression plate 42 cases,monolateral fixator 26 cases,embracing fixator 28 cases);revolving self-lock nails 39 cases.Result]The operative time,volume of blood loosing,the radial nerve injury,the infection rate and the breakage rate of the group treated with normal operative therapy were obviously more than the group treated with revolving self-lock nails,and the satisfactory rate after operation of the group treated with normal operative therapy was less than the group treated with revolving self-lock nails.Conclusion]Revolving self-lock nails can avoid much shortcoming of transverse locking nails.The advances of revolving self-lock nails are convenient in operative procedure,with little invasive of operation,solid internal fixation and safety compared with the normal operative therapy.And revolving self-lock nails has two kind choices:anterograde transfixation and retrograde transfixafion,thus it can protect function of shoulder joint in some ways,so revolving self-lock nails is one of the idea choices to treat the fracture of shaft of humerus.In opposition,normal operative has much shortage and it is restricted by type of fractures.