医源性因素对肱骨近端骨折疗效的影响

目的探讨治疗肱骨近端骨折中出现的各种失误和并发症与医源性因素的关系,并提出相应对策。方法回顾总结37例治疗肱骨近端骨折中出现的失误和并发症,分析其原因及所作出相应处理的价值。结果35例得到随访,采用Neer功能评定标准进行评分,优良率为94.3%。无骨折移位、畸形愈合及内固定松动等情况发生。结论治疗肱骨近端骨折中出现的失误和并发症与术前准备、术式的选择、手术技术及术后功能锻炼指导等医源性因素有关。

Effects of Iatrogenic Factors on Curative Outcome of Humeral Proximal Fractures

Objective To appraise the correlation between iatrogenic factors and errors or complications which occur in the treatment of humeral proximal fractures.Methods A total of 37 patients of humeral proximal fractures were reviewed. The causes of errors and complications were analyzed.Results Of the 37 patients, 35 patients were followed up. According to Neer evaluation method, the excellent or good curative rate of joint funtion was 94.3%. All the fractures healed without the three complications (displacement, malformation and hardware fixation). Conclusion Errors and complications occurring in the treatment of humeral proximal fractures are related to such iatrogenic factors as inadequate preoperative preparation, improper operative approach choice, unskillful surgical technique and improper postoperative instruction for functional exercise.