远端带锁髓内针治疗肱骨干骨折术后并发桡神经损伤原因分析

目的探讨肱骨干骨折应用远端带锁髓内针内固定治疗术后并发桡神经损伤的特点及病因分析。方法本院2009年4月～2012年1月收治肱骨干骨折患者42例，应用远端带锁髓内针内固定治疗术后并发桡神经损伤3例，分析其临床表现、致病原因、诊治方法。结果并发桡神经损伤病例均随访半年，其中2例完全恢复，另1例肌电图示完全性损伤，神经功能无恢复。结论解剖层次不清、髓内针锁钉特点、骨折部位是应用远端带锁髓内针治疗肱骨干骨折损伤桡神经的主要原因。熟悉解剖和改进医疗器械可能避免和减少损伤。

Reason analysis of radial nerve injury supervened after the surgery in the treatment of humeral shaft fracture by distal locking intramedullary needle

Objective To investigate the features and cause analysis of humeral shaft fracture in the application of radial nerve injury supervened after the surgery in the treatment of humeral shaft fracture by distal locking intramedullary needle.Methods Forty-two cases with humeral shaft fracture in our hospital from April 2009 to January 2012,in which there were 3 cases with radial nerve injury supervened after the surgery treated by distal locking intramedullary needle.The clinical manifestations,pathogenesis,diagnosis and treatment approach were analyzed.Results The cases of radial nerve injury supervened after the surgery were followed up for six months,there were 2 cases with fully recovered,EMG of the other one showed totality injury,neurological function was not recovery.Conclusion The main reason for application of radial nerve injury supervened after the surgery in the treatment of humeral shaft fracture by distal locking intramedullary needle are those:anatomical structures is unclear,the locking nail characteristics of intramedullary nail,the fracture site.Being familiar with the anatomy and improving medical devices may prevent and reduce the injury.