Department of Trauma and Orthopedic Surgery, Evangelismos General Hospital, Athens, Greece.
J Orthop Trauma. 2010 Apr;24(4):199-206. doi: 10.1097/BOT.0b013e3181b2b74d.
To evaluate the use of intramedullary nailing in the management of both "combined" and "extended" fractures of the humeral head and shaft.
Retrospective case series study.
Level I trauma center.
Twenty-one consecutive patients who underwent intramedullary nail insertion for "extended" or "combined," closed, nonpathologic fractures of the humeral head and shaft between October 1999 and December 2006 were included in the study. Two patients were lost to follow up and one died before fracture healing.
Evaluation of outcomes was assessed with the use of the Constant score.
There were no neurovascular problems or infections. Eighteen fractures united from 4 to 7 months postoperatively. One case of avascular necrosis of the humeral head, one case of acromion impingement, and one case of unacceptable loss of reduction occurred. Shoulder range of motion was not regained fully in any case and mild shoulder discomfort remained in eight patients. The mean Constant score for all 18 patients was 74.4 (range, 20-95) for the affected side and 89.17 points for the uninjured side. The percentage created from the mean affected/unaffected side scores was 83.4%.
Intramedullary nailing for proximal humeral fractures associated with shaft extension or segmental involvement appears to offer a reliable treatment option.
评估髓内钉在治疗肱骨头和骨干的“合并”和“扩展”骨折中的应用。
回顾性病例系列研究。
一级创伤中心。
纳入研究的 21 例连续患者均因肱骨头和骨干闭合性、非病理性“扩展”或“合并”骨折，于 1999 年 10 月至 2006 年 12 月期间接受髓内钉插入治疗。2 例患者失访，1 例患者在骨折愈合前死亡。
使用 Constant 评分评估结果。
无神经血管问题或感染。18 例骨折在术后 4 至 7 个月内愈合。发生 1 例股骨头缺血性坏死、1 例肩峰撞击和 1 例无法接受的复位丢失。在任何情况下，肩部活动范围均未完全恢复，8 例患者仍有轻度肩部不适。18 例患者的平均 Constant 评分，患侧为 74.4（范围为 20-95），健侧为 89.17 分。从平均患侧/健侧评分计算得出的百分比为 83.4%。
髓内钉治疗肱骨干合并或节段性骨折似乎是一种可靠的治疗选择。
