Dağlar Bülent, Delialioğlu Onder Murat, Taşbaş Bülent Adil, Bayrakçi Kenan, Ağar Mustafa, Günel Uğur
Ankara Numune Eğitim ve Araştirma Hastanesi 4. Ortopedi ve Travmatoloji Kliniği.
Acta Orthop Traumatol Turc. 2007;41(1):7-14.
We compared the results of plate-screw fixation and intramedullary fixation with inflatable nails for the treatment of acute humeral diaphyseal fractures.
The study included 34 patients (20 females, 14 males; mean age 36.4 years; range 18 to 62 years) who were selected from patients treated with plate-screw fixation or inflatable intramedullary nails. The groups were matched for age, sex, severity of fracture, and the type of humeral fracture. Eighteen fractures were treated in each group. Classification of humeral fractures and open fractures were made according to the AO and Gustilo-Anderson systems, respectively. Functional evaluations were made at postoperative six and 12 months using Constant shoulder and Mayo elbow performance scores. All the patients were administered the Short-Form 36 (SF-36) questionnaire at 12 months. The two groups were compared with respect to operation time, perioperative need for blood transfusion, time to union, complications, and shoulder and elbow functions.
The mean operation time was significantly shorter (25.3 min vs 66.1 min; p<0.001) and the need for blood transfusion was significantly less (p=0.001) with inflatable intramedullary nails. Constant shoulder and Mayo elbow scores did not differ significantly between the two groups. Implant failure was only encountered with plate-screw fixation in three patients. Union problems were observed in five patients (3 plate-screw, 2 intramedullary nail). Following plate-screw fixation, two patients developed superficial infection, two patients developed transient radial paralysis.
Inflatable intramedullary nails can be used safely in the treatment of acute humeral diaphyseal fractures without increasing union problems and complications.
我们比较了钢板螺钉固定和带充气髓内钉的髓内固定治疗急性肱骨干骨折的效果。
该研究纳入了34例患者（20例女性，14例男性；平均年龄36.4岁；范围18至62岁），这些患者选自接受钢板螺钉固定或充气髓内钉治疗的患者。两组在年龄、性别、骨折严重程度和肱骨骨折类型方面进行了匹配。每组治疗18例骨折。肱骨骨折和开放性骨折分别根据AO和Gustilo-Anderson系统进行分类。术后6个月和12个月使用Constant肩关节和Mayo肘关节功能评分进行功能评估。所有患者在12个月时接受简短健康调查问卷（SF-36）。比较两组的手术时间、围手术期输血需求、骨折愈合时间、并发症以及肩关节和肘关节功能。
充气髓内钉组的平均手术时间明显更短（25.3分钟对66.1分钟；p<0.001），输血需求明显更少（p = 0.001）。两组之间的Constant肩关节和Mayo肘关节评分无显著差异。仅3例接受钢板螺钉固定的患者出现植入物失败。5例患者出现骨折愈合问题（3例钢板螺钉固定，2例髓内钉固定）。钢板螺钉固定后，2例患者发生浅表感染，2例患者出现短暂性桡神经麻痹。
充气髓内钉可安全用于治疗急性肱骨干骨折，且不会增加骨折愈合问题和并发症。
