Li Xin-kui, Wang Hai-qiang, Wei Yi-yong, Wu Zi-xiang
Institute of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Chin J Traumatol. 2008 Dec;11(6):335-40. doi: 10.1016/s1008-1275(08)60068-1.
To introduce the experience of treating nonunions of humeral fractures with interlocking intramedullary nailing.
Twelve patients with humeral nonunions were treated with interlocking intramedullary nailing. The time interval between trauma and surgery was 10.5 months on average. Open reduction with anterograde approach was performed. Axial compression was specially applied to the fracture site with humeral nail holder after insertion of distal locked screws. Iliac bone grafting was added.
The average follow-up period was 21 months (ranging 9-51 months). All patients achieved osseous union 5.8 months after treatment on average. Eleven patients had good functions of the shoulder joints and the upper extremities. No patient experienced any permanent neurological deficit. Refracture of the original ununited region occurred in one patient after removal of the internal fixator one year later, but union was achieved after closed re-intramedullary nailing fixation.
Humeral interlocking intramedullary nailing is an effective alternative treatment for humeral nonunion.
介绍采用带锁髓内钉治疗肱骨干骨折不愈合的经验。
对12例肱骨干骨折不愈合患者采用带锁髓内钉治疗。受伤至手术的平均间隔时间为10.5个月。采用顺行入路切开复位。在远端锁定螺钉插入后，使用肱骨钉把持器对骨折部位进行轴向加压。并加用髂骨植骨。
平均随访21个月（9 - 51个月）。所有患者平均在治疗后5.8个月实现骨愈合。11例患者肩关节及上肢功能良好。无患者出现永久性神经功能缺损。1例患者在取出内固定器1年后原不愈合部位发生再骨折，但经闭合髓内钉再次固定后实现愈合。
带锁髓内钉是治疗肱骨干骨折不愈合的一种有效替代方法。
