肱骨干骨折不同手术固定方法的疗效评价

目的评价肱骨干骨折最佳固定方法。方法对采用加压钢板、交锁髓内钉、单侧纵轴动力外固定器三种固定方法治疗的176例肱骨干骨折患者进行疗效分析。结果本组病例均获骨性愈合。加压钢板组、交锁髓内钉组、单侧纵轴动力外固定器组平均愈合时间分别为7月、6月、5月。外固定器组固定物松动或断裂例数为10例(13.2%),与其他组比较无显著差异(P>0.05);骨折延迟愈合或骨不连、伤口感染、医源性桡神经损伤、肱动脉损伤及1次、2次、3次各手术次数例数分别为4(5.3%)、3(3.9%)、7(9.2%)、4(5.3%)、72(94.7%)、4(5.3%)、0(0%),与其他组比较均有显著差异(P<0.05)。结论单侧纵轴动力外固定器是目前治疗肱骨干骨折的理想选择。

Choice of surgical fixation instruments for humeral shaft fracture

Objective To study the best surgical fixation instrument for humeral shaft fracture. Methods A total of 176 cases with humeral shaft fracture were t reated with plate and screws,interlock intramedullary nail and unilateral axial dynamic fixator. Results All of 176 cases attained bony union.The average union time:plate and screws costed 7 months;interlock intramedullary nail 6 months;un ilateral axial dynamic fixator 5 months.Loosen and broken unilateral axial dynam ic fixator happened in 10 cases(13.2%), and there was no remarkable difference i n the three groups(P>0.05).The cases, delayed union or nonunion, infected wound, nosocodial injury of radial nerve, injury of brachial artery and operational fr equencies, from one to three, made a significant difference(P<0.05). As for unil ateral axial dynamic fixator, there were respectively 4 cases(5.3%), 3 cases(3.9 %), 7 cases(9.2%), 4 cases(5.3%), 72 cases(94.7%), 4 cases(5.3%), 0 cases (0%). Conclusions The unilateral axial dynamic fixator is the choice of treatment for humeral shaft fracture.