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钛弹性髓内钉治疗成年组肱骨干骨折的临床疗效

Clinical Outcome of Treatment of Diaphyseal Fractures of Humerus Treated by Titanium Elastic Nails in Adult Age Group.

作者信息

Verma Amit, Kushwaha Sudhir Shyam, Khan Yasir Ali, Mohammed Farid, Shekhar Subhanshu, Goyal Ankur

机构信息

Assistant Professor, Department of Orthopaedics, Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India.

Associate Professor, Department of Orthopaedics, Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India.

出版信息

J Clin Diagn Res. 2017 May;11(5):RC01-RC04. doi: 10.7860/JCDR/2017/26449.9812. Epub 2017 May 1.

Abstract

INTRODUCTION

Humerus shaft fracture is one of the most common injuries to the musculoskeletal system, which are managed both conservatively and surgically. There are pitfalls, advantages and disadvantages in each method. The individual fracture analysis determines the therapeutic options.

AIM

To assess the clinical outcome of treatment of diaphyseal fractures of humerus treated by Titanium elastic nail in adult age group by DASH scoring.

MATERIALS AND METHODS

It was a prospective study of 20 cases of diaphyseal fracture of humerus admitted to Era's Lucknow Medical College and Hospital between October 2014 and September 2015 treated with close reduction and internal fixation with titanium elastic nail. Functional outcome was evaluated using DASH scoring system and radiological outcome was evaluated by serial radiographs. The data was processed with SPSS software version 16.0 (Chicago, inc. USA) and it was summarized in proportion and percentage.

RESULTS

In our series of 20 patients, 17 were males and three were females. Most of the patients were between 30-50 years of age (mean 38 years). Most common mode of injury, side of involvement, level of fracture and fracture type were road traffic accidents (60%), right side (53.3%) and mid one third (75%), transverse (60%) respectively. So, in 65% of the patients, there was no disability of arm shoulder and hand as DASH score was within normal range and in 15% of the patients the disability was mild to moderate as scoring was slightly higher than normal and in 20% the disability was severe as the DASH score could not be calculated because of non union.

CONCLUSION

Elastic nail fixation require very minimal soft tissue dissection and being a close reduction, the biology of the fracture is also not disturbed and the chances of nerve injury are much less and as the non union was seen in oblique and spiral fracture type hence it should be used with caution or else other alternative methods of fixation should be used.

摘要

引言

肱骨干骨折是肌肉骨骼系统最常见的损伤之一,其治疗方法包括保守治疗和手术治疗。每种方法都有其陷阱、优点和缺点。个体骨折分析决定治疗方案。

目的

通过DASH评分评估钛弹性髓内钉治疗成年组肱骨干骨折的临床疗效。

材料与方法

这是一项前瞻性研究,对2014年10月至2015年9月在埃拉的勒克瑙医学院和医院收治的20例肱骨干骨折患者进行了闭合复位并用钛弹性髓内钉内固定治疗。使用DASH评分系统评估功能结果,通过系列X线片评估放射学结果。数据用SPSS软件16.0版(美国芝加哥公司)进行处理,并以比例和百分比进行总结。

结果

在我们的20例患者系列中,男性17例,女性3例。大多数患者年龄在30至50岁之间(平均38岁)。最常见的损伤方式、受累侧、骨折水平和骨折类型分别为道路交通事故(60%)、右侧(53.3%)和中三分之一(75%)、横行(60%)。因此,65%的患者手臂、肩部和手部无残疾,因为DASH评分在正常范围内;15%的患者残疾为轻度至中度,因为评分略高于正常;20%的患者残疾严重,因为由于骨不连无法计算DASH评分。

结论

弹性髓内钉固定所需的软组织剥离非常少,由于是闭合复位,骨折的生物学特性也未受到干扰,神经损伤的几率也小得多,并且由于在斜形和螺旋形骨折类型中可见骨不连,因此应谨慎使用,否则应采用其他替代固定方法。

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