顺行交锁髓内钉与逆行交锁髓内钉治疗肱骨干骨折的疗效比较
[Comparison of the results of the treatment of humeral shaft fractures with antegrade locked intramedullary nailing and retrograde locked intramedullary nailing].
作者信息
Liu Xing-hua, Sun Lin, Jiang Xie-yuan, Wang Man-yi, Zhang Li-dan
机构信息
Department of Orthopaedic Trauma Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2007 Apr 3;87(13):902-5.
OBJECTIVE
To compare the results of using antegrade locked intramedullary nailing and the retrograde locked intramedullary nailing in the treatment of humeral shaft fractures.
METHODS
From January 1999 to December 2003, 92 closed humeral shaft fractures were operated with locked intramedullary nail. There were 92 patients, 67 men, 25 women, mean age 37 years (range 18 to 72 years). There were 69 antegrade nailing and 23 retrograde nailing. The average followup of the others was 28 months (12-70 months).
RESULTS
The difference between the two groups' operation time, union rate and Mayo elbow performance score were not statistically significant. However, there were statistic significance between the two groups' intraoperative complication rate and Constant-Murley shoulder score.
CONCLUSION
There is a much higher rate of iatrogenic fracture when retrograde nailing are performed. Antegrade nailing may influence the function of shoulder, but it's easier to manipulate.
目的
比较顺行交锁髓内钉与逆行交锁髓内钉治疗肱骨干骨折的效果。
方法
1999年1月至2003年12月，92例闭合性肱骨干骨折患者接受了交锁髓内钉手术。患者共92例，男性67例，女性25例，平均年龄37岁（18至72岁）。其中顺行髓内钉固定69例，逆行髓内钉固定23例。其余患者平均随访28个月（12至70个月）。
结果
两组手术时间、骨折愈合率及梅奥肘关节功能评分差异无统计学意义。然而，两组术中并发症发生率及Constant-Murley肩关节评分差异有统计学意义。
结论
逆行髓内钉固定时医源性骨折发生率更高。顺行髓内钉固定可能影响肩关节功能，但操作更简便。
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