带血管蒂骨膜瓣移位修复肱骨骨折及骨不连

目的 探讨带血管蒂的肱骨远端骨膜瓣移位修复肱骨难愈性骨折及骨不连。方法 1995年以来应用该骨膜瓣修复肱骨难愈性骨折及骨不连23例，其中粉碎性、多段骨折等难愈合性骨折12例，骨不连11例，合并桡神经损伤7例。手术方式为开放复位，内或外固定及应用带血管蒂骨膜瓣移位覆盖骨断端。结果 术后经6－24个月随访，除2例骨不连患者对关节活动不满意外，其余病例均获得良好的效果，骨膜瓣成骨好。难愈性骨折愈合时间为2－3个月，骨不连愈合时间为3－5个月，桡神经功能均恢复。结论 桡侧副血管蒂肱骨远端骨膜瓣对肱骨骨折及骨不连具有很好的修复作用。

REPAIR OF HUMERAL FRACTURE AND NON-UNION WITH TRANSFER OF VASCULARIZED PERIOSTEAL FLAP

Objective To study the results of humeral fracture and non union repaired by vascularized periosteal flap transfer. Methods The clinical data of humeral fracture and non union in 23 cases were analysized retrospectively since 1995. Among them, minuted or several segmental fracture in 12 cases, non union in 11 cases, and following injury of radial nerve in 7 cases. The operative method was open reduction, inner or external fixation with vascularized periosteal flap transfer. Results The period of follow up was 6 months to 2 years. The repair result of all patients was excellent and good, but elbow joint motion in 2 cases of non union was not satisfactory. The periosteal flap had good osteogenic ability. The period of bone union was 2 to 5 months in humeral fracture and non union. And function of radial nerve was recovery. Conclusion Transfer of distal humeral periosteal flap pedicled with radial collateral vessels is a better method for humeral fracture and non union.