AO非扩髓肱骨交锁髓内钉在肱骨干骨折不愈合中的应用

目的 探讨AO非扩髓(AO—UHN)肱骨交锁髓内钉加自体松质骨植骨在肱骨干骨折不愈合中的应用。方法 20例患者手术取出原内固定，行正向或逆向插入AO—UHN肱骨交锁髓内钉，在不愈合部位行丰富的自体松质骨植骨。术后进行影像学观察和疗效评定。结果 20例患者有15例得到随访，随访时间为9～23个月(平均13．8个月)，愈合时间4～10个月(平均6．2个月)。除1例在12个月时仍未愈合予再次植骨后6个月获得愈合外，其余均在一次手术后获得愈合，优良率为90％。结论 AO—UHN肱骨交锁髓内钉加自体松质骨植骨是治疗肱骨干骨折不愈合的一种有效方法。

Treatment of humeral diaphyseal fracture nonunion with AO unreamed humeral intramedullary locking nails

Objective To evaluate clinical outcomes of AO UHN humeral intramedullary locking nail in treatment of humeral fracture nonunion. Methods 20 cases of humeral diaphyseal fracture nonunion received operations to remove their previous instruments. After AO UHN was inserted via antegrade or retrograde approach, the opulent autogenous cancellous bone was grafted at the location of nonunion. Roentgenographic evaluation and functional outcome assessment were conducted. Results 15 of the 20 cases were available for follow up. The follow ups lasted 9 to 23 months (averaging 13.8 months). The healing time was 4 to 10 months (averaging 6.2 months). All the patients healed after the first operation except one, whose nonunion refused to heal after 12 months and had to undergo the second operation with another auto graft and healed 6 months after the reoperation. The total excellent and fine rate was 90%. Conclusion AO UHN humeral intramedullary nail fixation with auto cancellous bone graft is effective for treatment of humeral diaphyseal fracture nonunion.