髓内针与钢板治疗肱骨干闭合性骨折疗效比较

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1、摘要:目的比较交锁髓内针和加压钢板治疗肱骨干骨折的疗效。方法手术治疗83例，交锁髓内针固定31例，加压钢板固定52例，比较两种技术手术吋间、住院时间、骨折愈合时间等疗效指标和骨不连、橈神经损伤、肩关节功能障碍等并发症情况。结果与钢板内固定相比，交锁髓内针固定手术时间短，骨折愈合快，住院治疗时间接近。髓内针固定未发生骨不连，钢板固定有8例发生骨不连。一过性橈神经麻痹髓内针与钢板分別为2例、7例，肩关节功能障碍分別为2例、5例，所有病例均未感染。结论与钢板相比较，交锁髓内针治疗肱骨干骨折治愈率高，并发症少。关键词肱骨干骨折髓内针钢板内固定AC

2、oparisonbetweentheLockingIntramedullaryNailandthePlateforTreatmentofHumeralShaftCloseFractures.BaiYong-zhe,XuTie-ying,SunYan-guang.ShanhaiguanPeople'sHospitahQinhuangdao,Hebei,066200,China[Abstract]ObjectiveTocomparethetherapeuticefficiencybetweenthelockingintramedullaryn

3、ailandtheplatefortreatmentofhueralshaftclosefracturees.Methods83patientswithhueralshaftclosefractureesweredividedintothelockingintramedullarynailgroup(31cases)andtheplategroup(52cases)-Theywerecomparedintermofoperation,hospitalization,fracturehealingtimeandtheoccuiTenceof

4、postoperativecomplicationbetweenthetwogroups.ResultsBycomparisonwiththeplategroup,thelockingintramedullarynailgrouphadashotteroperatingtimeandanearlierfractureunion.Therewasnostatisticsdifferenceinthetimeofhospitalizationbetweenthetwogroups.Nonunionoccurred8casesinplategr

5、oup.Radialnervepalsyocceredin2casesofintramedullarynailand7casesofplategroup・Theobstructionofshoulderjointfunctionwashappenedon2casesofintramedullarynailgroupand5casesofplategroup.Noinfectionwashappenedinallcases.ConclusionTheclinicalresultsofuseoflockingintramedullarynai

6、laremoreexcellentthanplatesinthetreatmentofhueralshaftclosefracturesbecauseofthecharacteristicofearlyrecoveryandlesscomplications.【Keywords]Hueralshaftfractures；Intramedullarynail；Plate；Internalfixation交锁髓内针和加压钢板固定肱骨干骨折是较为常用的两种方法，为比较两种方法在肱骨干骨折方面的疗效，选择我科口1996-2006年分别采用交锁髓内

7、针内固定及加压钢板内固定治疗的肱骨干骨折患者共83例，就其结果作比较，以期为肱骨干骨折治疗方法的选择提供参考。1临床资料1.1一般资料木组共83例。其屮髓内针固定组组31例，男22例，女9例,年龄25-55岁，平均41.3岁；钢板固定组52例，男37例女15例，年龄22〜56岁，平均47.4岁。受伤原因:车祸28例,摔伤38例，砸伤17例。骨折分型:按AO分型系统，髓内针组A型16例，B型10例，C型5例，钢板组A型27例，B型18例，C型7例。1.2治疗方法术前摄肱骨全长X线片，全面了解骨折情况。选择钢板长度至少是骨折端骨干直径的4倍，

8、或远近主骨分别至少3枚螺丝钉固定。髓内针长度确定以健侧肱骨肩峰至鹰嘴的长度减去3-4cm,直径为X线片最狭窄部髓腔宽度减去1—2cm。髓内针固定组采用闭合复位顺行插针技术，C型臂透视下复位，采