交锁髓内钉治疗肱骨干骨折的临床疗效

目的总结肱骨交锁髓内钉治疗肱骨干骨折的临床疗效。方法对132例肱骨干骨折患者行非扩髓交锁髓内钉固定，其中新鲜骨折115例、病理性骨折14例、陈旧性骨折骨不连3例，伴桡神经损伤4例。新鲜骨折患者行闭合复位，病理性骨折和陈旧性骨折骨不连患者行切开复位植入自体骨并加入骨形态发生蛋白(BMP)。结果平均随访16．5个月，124例骨折愈合，骨折愈合率为93．9％，骨折平均愈合时间为20．5周。肩关节功能按Neer评分法测定，优良率为91．7％。4例桡神经损伤者术后6个月内功能恢复。4例术后残留肩部疼痛。无一例发生切口感染、医源性骨折及腋神经损伤等。结论肱骨交锁髓内钉可作为治疗肱骨干骨折的首选方法，尤其适用于病理性骨折、多段骨折、粉碎骨折及陈旧性骨折骨不连的治疗。

Preliminary report on humeral shaft fracture treated with interlocking intramedullary nail

Objective To determine the effectiveness of interlocking intramedullary nail for humeral shaft fracture. Methods 132 cases of humeral shaft fracture were treated with Interlocking intramedullary nail including latest fractures in 115, pathological in 14 and non-union in 3. Four patients had radial nerve palsy. Results With an average of 16.5 months follow-up, shoulder pain was present in 4 patients with pain at the fracture site in 2. 124 cases of healed fracture showed the mean union time as 20.5 weeks. The shoulder and elbow functions were excellent or good in 91.7%. Four cases of radial nerve palsy recovered spontaneously six months postoperatively.There was no infection or axillary nerve injury or iatrogenic fracture. Conclusion Interlocking intramedullary nail is the first choice of effective treatment for humeral shaft fracture, especially in patients with pathological, non-union, segmental and comminuted fractures.