微创内固定加外固定治疗肱骨干长斜形与螺旋形骨折

目的]评价微创内固定结合外固定治疗肱骨干长斜形与螺旋形骨折的临床疗效。方法]24例肱骨干长斜形与螺旋形骨折按AO分类，A1型6例，B1型11例，C1型7例，均采取有限切开复位、微创螺钉内固定结合适宜的外固定进行治疗，术后进行科学合理的康复治疗。结果]经术后6-15个月、平均9．5个月随访，24例骨折均获临床愈合，愈合时间为3—8个月，平均3．5个月。根据Rodriguez—Merchan EC的肩、肘关节功能评价标准，肩、肘关节功能优17例，良5例，可2例，总体优良率达91．7％，无感染、医源性骨折及周围神经损伤等并发症。结论]微创螺钉内固定加外固定治疗肱骨干长斜形与螺旋形骨折，符合生物力学原理和微创治疗原则，操作简单，固定稳妥，功能恢复满意。

Long oblique and spiral fracture of humeral shaft treated with minimally invasive internal fixation combined with external fixation

Objective]To evaluate the clinical effects of long oblique and spiral fracture of humeral shaft treated with minimally invasive internal fixation combined with external fixation.Method]Twenty-four cases with long oblique and spiral fracture of humeral shaft,according to AO classification,6 cases were type A1, 11 cases Type B1 and 7 cases Type C1,were treated with limited open reduction and minimally invasive internal fixation with screws and combined with proper external fixation.Scientific and rational rehabilitative treatment was carried out in each case after the operation.Result]The post-operation follow-up ranged from 6 to 15 months with an average of 9.5 months,all the fractures were healed well,and the average clinical healing period was 3.5 months(from 3 to 8 months).According to Rodriguez-Merchan EC's criteria,functional recovery of shoulder and elbow of all cases were excellent in 17 cases,good in 5,fair in 2,and none was poor,the excellent and good rate was 91.7%.There were no complications in all cases,such as infection,iatrogenic fracture and peripheral nerve injury.Conclusion]Minimally invasive internal fixation combined with external fixation is an effective method to treat long oblique and spinal fracture of humeral shaft because of its consistent with biomechanic and minimally invasive principle,convenient for clinical application,reliable fixation,satisfactory functional recovery and it worth recommending.