交锁髓内钉治疗肱骨病理骨折

目的评估采用交锁髓内钉及骨水泥强化方法治疗肱骨干及近端病理骨折的疗效。方法回顾2005年1月至2009年6月间采用顺行交锁髓内钉及骨水泥强化方法治疗的15例肱骨病理骨折的治疗情况,其中11例病理骨折,4例濒临骨折。结果 15例中,男11例,女4例,平均年龄51.1岁（29～65岁）。5例病变位于近端1/3,10例位于中1/3。平均手术时间121min（85～177min）,平均出血量650ml（400～1200ml）。4例接受输血（平均输血量RBC 2.3U）。12例术后随访超过12个月。其中10例结果优良。2例诉肩部僵硬。结论交锁髓内钉治疗肱骨病例性骨折,可提供稳定的固定并允许患肢早期活动。骨水泥强化是治疗节段性骨缺损的有效方法。

Treatment of metastatic humeral fracture with a locked intramedullary nail

Objective To assess the use of a new humeral nail and cement augmentation to treat metastatic fractures of the humerus.Methods Totally 15 patients received locked intramedullary nails from January 2005 to June 2009.Of them,there were 11 for pathological fractures and 4 for impending fractures.All the nails inserted anterograde and cement augmentation was applied in all the patients.Results There were 11 male and 4 female patients,mean age was 51.1 years（range 29-65 years）.Lesion located in proximal third in 5 patients,and middle third in 10 patients.The mean operation time was 121 min（range 85-177 min）.The mean blood loss was 650 ml（range 400-1200 ml）,4 patients received blood transfusion（mean 2.3 U of RBC）.12 cases were followed up 12 months after operation and 10 patients got excellent or good results.2 patients complain shoulder stiffness.Conclusion Locked intramedullary nail can be used in treating pathological fractures of humerus,which provide stable fixation and allow early movement of arm.Cement augmentation is a useful method in treating segmental bone defect.