分叉式髓内钉在治疗肱骨干骨折中的应用

目的探讨分叉式髓内钉治疗肱骨干骨折的疗效。方法本组肱骨干骨折27例，对8例肱骨上1／3骨折采用顺行穿钉法，对19例中下段骨折采用逆行穿钉法，对4例粉碎骨折采用辅助有限切口钢丝捆扎后再穿钉。结果全部病例获得随访，乎均14．2个月。骨折均愈合，26例临床愈合时间为8～12周，1例襞裂骨折发生延迟愈合，临床愈合时间为22周。肩肘关节功能按Neer评分标准评分，优23例，良4例。3例病人术后3个月肩肘关节活动度差，拔钉后功能锻炼1个月，先后恢复良好，无医源性血管神经损伤。结论分叉式髓内钉治疗肱骨干骨折具有创伤小、简便可靠、功能恢复好、并发症少等优点，是治疗肱骨干骨折的有效方法。

Operative Treatment of Humeral Shaft Fractures by Branch Locking Intramedullary Nails

Objective The paper discusses the curative effect of branch locking intramedullary nails in humeral fracture,and it represents the methods of operation and attention points. Methods Among 27 cases of humeral fracture,8 cases of fracture above one thirds of humeral are using sequential drill through method; 19 cases of fracture under one thirds of humeral are using reversal drill through method;4 cases of smashing fracture were using the restrictive incision steel wire and drilled through the nails. Results All of the cases were followed up, 14.2 months on an average, fracture were union ,the time of union of 26 cases need 8 to 12 weeks,1 case of breakage fracture heals up later, it needs 22 weeks. The function of shoulder and elbow were based on Neer grade standard, 23 cases were excellent, 4 cases were good. 3 cases reflect that the patients＇ shoulder and elbow＇s bad movement after operating 3 months,and after pulling out the nails and exercised one month,all the patients recovered well,there were no medical vessel or nerve injury. Conclusion The advantages of using locking intramedullary nail in humeral fracture were less invasive, simple ,excellent effects and less syndromes. It is one of the most effective method in curing humeral fracture.