顺行交锁髓内治疗肱骨干骨折不愈合

目的 评价顺行交锁髓内钉治疗肱骨干骨折不愈合的临床效果。方法 对13例肱骨干骨折不愈合采用自体髂骨移植，顺行Russell-Rayler交锁髓内钉治疗。术后行X线片检查和肩关节功能评估。结果 平均随访18个月（14－25个月），13例均获骨愈合，平均愈合时间4．3个月（3－7个月）。肩关节功能：优9例，良3例，一般1例。肩关节功能完全恢复9例，3例有来自近端交锁螺钉的肩关节撞击症状。结论 对肱骨干骨折不愈合可采用顺行交锁髓内钉治疗；为促进骨愈合，骨端加压和骨移植是必要的。

Treatment of nonunion of fracture humeral shaft with antegrade interlocking nails

Objective　To evaluate the clinical effects of antegrade interlocking nailing for humeral shaft nonunions. Methods　13 patients with humeral shaft nonunions were treated by internal fixation of antegrade interlocking nail with autologous bone grafts. The outcomes were assessed by radiographs and evaluation of function. Results　It is found that all cases acquired solid bony union with a mean healing time of 4.3 months(3～7 months) through 18 months follow-up on average(14～25 months). Shoulder functional results were excellent in 9 cases, good in 3 cases and fair in 1 case. 9 cases had complete recovery of shoulder range of motion, 3 cases had shoulder impingement caused by proximal locking screws. Conclusion　Humeral shaft nonunions may be managed by using antegrade interlocking nails；autologous bone grafts and fixation with compressive force on both ends of humeral are necessary for enhancing bone healing.