肱骨干骨折内固定失败与骨折不愈合的相关分析及对策

目的通过治疗并随访肱骨干骨折内固定失败骨折不愈合病例，分析内固定失败与骨折不愈合的相关联系，探讨肱骨干骨折正确的内固定方法。方法19例肱骨干骨折内固定失败骨折不愈合病例，手术取出原内植物，重新复位植骨及坚强内固定。结果术后随访7～18个月，17例骨性愈合，骨折愈合率达89．5％。结论内固定不稳是肱骨骨折不愈合的主要危险因素。提高肱骨骨折愈合率关键是正确选择内植物，术中规范操作，提高内固定的稳定性。

Analysis and Treatment of Nonunion of Humeral Fractures with Unstable Internal Fixation

Objective To analyze the relationship between the nonunion and the failure of the internal fixations in order to find correct approach for the internal fixation by studying and following up nonunion of the humeral fracture associated with unstable fixation.Methods From January 2002 to February 2006,19 patients with instable internal fixation and nonunion were treated.The fracture of humerus was reduced again and fixed with stable fixators. Results Postoperative follow-up ranged from 7 to 18 months in all patients.Seventeen of the 19 patients treated with reoperation had excellent results.The rate of the humeral fracture union was 89.5%.Conclusion The main risk factor for the nonunion of humeral fractures is the unstable fixations.The key of improving in the rate of the nonunion of humeral fracture is how to select internal fixation.