外固定器加小夹板外固定治疗肱骨干骨折

目的:探讨外固定器加小夹板外固定治疗肱骨干骨折的疗效。方法:以单臂外固定器加小夹板外固定治疗肱骨干斜形、螺旋形、粉碎性及多节骨折36例。其中,男25例,女11例;年龄为14~82岁,平均34·4岁。按AO/ASIF分类:A2型11例,B型19例,C型6例。观察骨折临床愈合时间及手术后并发症。以“Constant肩关节评分法”评价肩关节功能,以“关节活动范围测量”评价肘关节功能。结果:随访7~15个月,平均9·3个月。所有骨折均达功能复位或解剖复位,术后平均12周(9~25周)达临床愈合。术后平均7周(4~13周)拆除小夹板,术后平均12周(9~25周)拆除外固定器。最后随访时Constant肩关节评分平均为96分(89~100分),而肘关节功能不受影响。无并发症发生。结论:该疗法用于治疗不稳定性肱骨干骨折具有简便易行、创伤少、固定牢、费用低等优点。两种固定方法同时使用可以取长补短,提高疗效,值得推广。

External fixator in combination with small splint for the treatment of humeral shaft fracture

Objective:To study therapeutic effect of external fixator in combination with small splint for the treatment of humeral shaft fracture.Methods:Thirty-six patients with humeral shaft fracture including oblique fracture,spiral fracture,comminuted fracture and multi-segment fracture were treated with unilateral external fixator combined with small splint fixation.Among them,25 patients were male and 11 patients were female,ranging in age from 14 to 82 years(mean 34.4 years).According to AOASIF standard,11 patients were classified as Type A_2, 19 as Type B,and 6 as Type C.The fracture healing time and postoperative complications were studied.Shoulder function was evaluated according to Constant-Murley shoulder assessment,and elbow function was evaluated by using range-of-motion measurements.Results:All the patients were followed up from 7 to 15 months, with an average of 9.3 months.All fractures had functional or anatomical reduction,and reached clinical healing at a mean time of 12 weeks after operation(from 9 to 25 weeks).The small splint and external fixator were removed at a mean time of 7 weeks(from 4 to 13 weeks )and 12 weeks(from 9 to 25 weeks)respectively after operation.The mean Constant shoulder score was 96 points at the last follow-up(from 89 to 100 points). The elbow function recovered to normal.No postoperative complications occurred.Conclusion:This combined external fixation method for the treatment of unstable humeral shaft fracture has such advantages as simple operation,little operative trauma,stable fixation and low cost.The two external fixator(the unilateral external fixator and the splint)could mutually make up their deficiencies when applied simultaneously,so as to reach better therapeutic effects.