髓内钉和微创钢板在肱骨干骨折内固定治疗中的应用

背景：随着微创技术的开展,髓内钉和微创钢板内固定广泛应用于肱骨干骨折并取得良好效果,但也并存一些并发症,如何  改进内固定的设计及操作以减少或避免并发症成为研究热点。目的：总结近年来肱骨干骨折微创内固定的治疗进展。方法：由第一作者检索PubMed/MEDLINE(http://www.ncbi.nlm.nih.gov/PubMed)、Web of knowledge (http://apps. isiknowledge.com)、OVID(http://ovidsp.tx.ovid.com)、Elsevier(http://www.sciencedirect.com)、中国期刊网(http://epub. edu.cnki.net)及万方数据库(http://wanfang.lib.sjtu.edu.cn)2005/2010有关髓内钉和微创钢板内固定治疗肱骨干骨折的文献,英文检索词为“humeral shaft fractures,internal fixation,minimally Invasvie”,中文检索词为“肱骨干骨折,微创,内固定”。排除重复性研究及肱骨干病理性骨折相关文献,纳入32篇文献进行综述。结果与结论：只有准确掌握肱骨干骨折及不同内固定种类的特点,做到个体化治疗,才能达到最好的治疗效果并最大程度减少并发症。目前深化了对肩袖损伤的认识,初步寻找到减少肩袖损伤的方法,改进了髓内钉及钢板的设计,在方便操作、减少手术时间的同时一定程度上避免了神经血管损伤。

Intramedullary nailing and minimally invasive plating osteosynthesis technique for humeral shaft fractures

BACKGROUND:With the development of minimally invasive surgery, intramedullary nailing and minimally invasive plates for humeral shaft fractures get a good clinical result, but also have some complications. How to improve design of the internal fixation and operation, to reduce or avoid the complications becomes a research hotspot.OBJECTIVE:To review the research and progress in treatment of humeral shaft fractures in recent years.METHODS:PubMed/MEDLINE, Web of knowledge, OVID, Elsevier databases, Chinese National Knowledge Infrastructure (CNKI), Wanfang database were retrieved by computer with key words of “internal fixation; minimally invasvie plating osteosynthesis; humeral shaft fractures” in Chinese and English to search papers published between January 2005 and January 2010. According to inclusion criteria, 32 literatures were selected in this review.RESULTS AND CONCLUSION:Only accurately grasping characteristics of internal fixation and each fracture, using individual treatment, we could be get the best clinical results and reduce the complications mostly. The people have deepen recognition of rotator cuff injury in some extent, finded some way to prevent damages preliminarily and improved the design of intramedullary nailing and plates which is easy for the operation and reduce the time and avoid the risk of neurovascular injury in a certain degree.