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自锁髓内钉内固定治疗肱骨干骨折 总被引:1,自引:0,他引:1
目的探讨自锁髓内钉治疗肱骨干骨折的疗效。方法2003年3月~2005年3月采用肩人路顺行自锁髓内钉内固定治疗32例肱骨干骨折患者,其中新鲜骨折30例,陈旧性骨折骨不连2例。术后根据肩、肘关节活动范围对其功能进行评价。结果所有患者术后获4~18个月(平均9个月)随访,骨折均愈合,愈合时间为12~20周。肩、肘关节功能按陈子华等标准进行评价:优23例,良8例,差1例,优良率为96.9%。术后无继发性桡神经损伤、切口感染及骨不连发生。结论自锁髓内钉治疗肱骨干骨折具有固定可靠、创伤小、并发症少、干扰轻等优点,骨折愈合率高,功能恢复良好,适合临床应用。 相似文献
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2001年4月至2004年2月,我院采用肱骨自锁髓内钉逆行置入治疗肱骨干骨折9例,取得良好效果,现报告如下。 相似文献
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目的探讨肱骨自锁髓内钉在肱骨干骨折临床治疗上的应用价值。方法对60例肱骨干骨折患者采用肱骨自锁髓内钉治疗30例、肱骨交锁髓内钉治疗30例,观察两组手术时间、出血量、切口愈合情况、早期活动时间、骨折愈合时间和关节功能恢复情况,并进行统计学分析。结果患者均获随访,时间12~18个月。两组手术时间、出血量比较差异有统计学意义(P<0.01);自锁髓内钉组手术时间短,出血量少。两组切口愈合情况、早期活动时间、骨折愈合时间和关节功能的恢复情况比较差异无统计学意义(P>0.05)。结论自锁髓内钉治疗肱骨干骨折具有固定牢靠、操作简单、手术创伤小、出血少的优点,是治疗肱骨干骨折较为理想的方法。 相似文献
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目的:研制一种新的肱骨内锁髓内钉,使操作更加简便。方法:使用该钉治疗肱骨干骨折43例,采用闭合或小切口复位的基础上插入该钉,形成内锁。结果:平均随访13~14个月,骨折全部愈合,肩关节功能优良率100%。结论:肱骨内锁钉具有操作简便,固定可靠,并发症少,创伤小,体现微创的原则。 相似文献
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目的探讨自锁髓内钉治疗肱骨干骨折的临床应用效果。方法利用自锁髓内钉治疗肱骨干骨折33例,评价其临床疗效。结果33例均获随访,随访12~48个月,平均26.5个月。骨折均愈合。按Neer评定标准,优21例,良10例,差2例,优良率93.9%。结论自锁髓内钉治疗肱骨干骨折具有损伤小、固定可靠、并发症少、骨折易愈合等优点,临床疗效满意,是治疗肱骨干骨折的理想内固定方法。 相似文献
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磁力导航交锁髓内钉内固定治疗股骨干骨折 总被引:1,自引:0,他引:1
股骨干骨折临床常见,约占全身骨折的6%[1],交锁髓内钉内固定术是目前最为常用的治疗方法之一.但由于受很多因素的影响,其远端锁钉的安装准确性低[2],有一定的失败率,影响了内固定效果.Durakbasa等[3]报告95枚远端锁钉中有23枚不成功,占24.2%. 相似文献
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Hollister AM Saulsbery C Odom JL Anissian L Garon MT Jordan J 《Techniques in hand & upper extremity surgery》2011,15(3):138-143
Humeral shaft fracture intramedullary nailing is less invasive than plates and screws. Antegrade technique has postoperative shoulder pain, increased rehab time, and frequent reoperation for rod removal. Published retrograde technique is not collinear with the shaft, has insertion site fractures (5% to 15%), and radial nerve palsies (5%). Our retrograde technique is collinear with the humerus shaft, simpler, and decreases operative fracture risk. The supine patient's elbow is fully flexed. A guide pin is inserted through the triceps tendon to the olecranon fossa roof, aligned with the humerus shaft, and drilled thought the cortex followed by the 6.5 mm cannulated drill through a small triceps splitting incision. The guide pin is passed along the humerus shaft and across the fracture. A small incision is made to identify and protect the radial nerve during reduction, reaming, and rod insertion. Flexible reamers are used and the nail placed and locked at least distally to prevent distal migration. An institutional review broad approved retrospective review of Louisiana State University Health Sciences Center adult humeral shaft fractures with retrograde technique from 1999 to January of 2009 was carried out. Sixteen patients were treated without perioperative fracture or nerve palsy. 相似文献
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Sala F Chiodini F Baù D Ceriani A Borromeo UM 《La Chirurgia degli Organi di Movimento》2002,87(3):163-168
25 humeral shaft fractures operated on at our institute with the intramedullary elastic Marchetti-Vicenzi nail were reviewed. Three were pathologic fractures. Patients mean age was 48 ranging from 13 to 95 years. The patients were followed until consolidation and shoulder and elbow function were evaluated with respectively the Constant and the Mayo Clinic score. All the fractures eventually healed with good clinical results. There were no major complications during nail insertion. The M-V nail has been shown to be a practical and reliable device, characterised by both an easy technique and a stable fixation, with a low complication rate and low X-rays exposure times. The choice of an elastic unreamed intramedullary nail, with a retrograde insertion, that allows a solid for proximal fixation by means of a bundle of divergent pins, has proven to be useful and safe for shoulder function. 相似文献
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From 1993 to present day, 110 metacarpal fractures in 89 patients were stabilised using a method of inserting a percutaneous intramedullary wire. This allowed for early unimpeded movement in wrist and hand together with ease of wire removal in clinic. Reduction was maintained in all patients until fracture healing, and there were no malunions. One was re-done owing to inadequate reduction intra-operatively, which thereafter united. One re-fractured and was subsequently treated non-operatively. There were two superficial infections. One patient was lost to follow-up at 4 weeks; the rest regained a full range of pain-free movement. In a final assessment of 62 patients, the mean DASH score was 4.6. We recommend this technique for metacarpal fractures that are: transverse and off-ended; angulated transverse or short oblique; multiple transverse or short oblique. We do not recommend this technique for long oblique or rotationally malaligned fractures. 相似文献
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膨胀自锁式髓内钉——一种新型骨折内固定材料 总被引:1,自引:0,他引:1
目前,交锁髓内钉内固定技术是治疗四肢长管状骨骨折的标准方法。但交锁髓内钉治疗需在x线透视下定位锁钉,常需扩髓,损伤髓内血供,由于应力集中于锁钉上,易导致远端锁钉断裂及骨折。因此,以色列一些学提出“膨胀自锁式髓内固定”的概念,根据这种全新的骨折内固定概念,设计出一种可以根据患髓腔空间改变主钉的直径、产生满意的抓握力、避免扩髓、无需远端锁钉及基本不使用x线辅助的新型髓内钉系统。[第一段] 相似文献
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Mahmoud A El-Rosasy 《Indian Journal of Orthopaedics》2012,46(1):58-64
Background:
Nonunion of humeral shaft fractures after previously failed surgical treatment presents a challenging therapeutic problem especially in the presence of osteoporosis, bone defect, and joint stiffness. It would be beneficial to combine the use of external fixation technique and intramedullary rod in the treatment of such cases. The present study evaluates the results of using external fixator augmented by intramedullary rod and autogenous iliac crest bone grafting (ICBG) for the treatment of humerus shaft nonunion following previously failed surgical treatment.Materials and Methods:
Eighteen patients with atrophic nonunion of the humeral shaft following previous implant surgery with no active infection were included in the present study. The procedure included exploration of the nonunion, insertion of intramedullary rod (IM rod), autogenous ICBG and application of external fixator for compression. Ilizarov fixator was used in eight cases and monolateral fixator in ten cases. The monolateral fixator was preferred for females and obese patients to avoid abutment against the breast or chest wall following the use of Ilizarov fixator. The fixator was removed after clinical and radiological healing of the nonunion, but the IM rod was left indefinitely. The evaluation of results included both bone results (union rate, angular deformity and limb shortening) and functional outcome using the University of California, Los Angeles (UCLA) rating scale.Results:
The mean follow-up was 35 months (range 24 to 52 months). Bone union was obtained in all cases. The functional outcome was satisfactory in 15 cases (83%) and unsatisfactory in 3 cases (17%) due to joint stiffness. The time to bone healing averaged 4.2 months (range 3 to 7 months). The external fixator time averaged 4.5 months (range 3.2 to 8 months). Superficial pin tract infection occurred in 39% (28/72) of the pins. No cases of nerve palsy, refracture, or deep infection were encountered.Conclusion:
The proposed technique is effective in treating humeral nonunion especially in the presence of osteoporosis and short bone segments. The inclusion of intramedullary rod as internal splint improves stability of fixation and prevents refracture after fixator removal. 相似文献19.
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Minna Laitinen Jyrki Nieminen Toni-Karri Pakarinen 《Archives of orthopaedic and trauma surgery》2011,131(4):503-508