Upadhyay A S, Lil N A
Department of Orthopaedics, SMT NHL Medical College and Vadilal Sarabhai General Hospital, Gujarat, India.
Malays Orthop J. 2017 Jul;11(2):53-59. doi: 10.5704/MOJ.1707.019.
Humerus shaft fractures in adults can be managed conservatively with functional braces or operatively with plate osteosynthesis or with intramedullary nailing. Conventionally humerus intramedullary nailing is done either using humerus interlocking nails or Enders nails. In this study we analyse the outcome of humerus shaft fractures (upper and middle third) managed with closed ante-grade intramedullary titanium elastic nailing in terms of union rates, union time, functional results and complications. A retrospective analysis of 25 patients treated with ante-grade intramedullary titanium elastic nailing was done during the period of August 2014 to June 2016 at our tertiary care centre. Skeletally mature patients with closed and acute fractures of the upper and middle shaft humerus of both sexes were included in the study. Twenty-five (100%) fractures united with an average consolidation time of 14.98 weeks (10-32 weeks), and no fractures ended in non-union. Nail impingement was seen in two (8%), shoulder stiffness in one (4%). Functional results were excellent in 22 (88%), moderate in two (8%) and poor in one (4%). There were 17 males and eight females with an average age of 39.08 years (range: 18-65 years). The average duration of hospital stay was 3.84±2.30 days. Closed ante-grade intramedullary titanium elastic nailing offers a safe and reliable method of fixing fractures of upper humeral shaft in adults. This method provides early fracture union, high union rates and less complications, in addition to early rehabilitation and reduces the hospital stay.
成人肱骨干骨折可采用功能性支具保守治疗，也可采用钢板内固定术或髓内钉固定术进行手术治疗。传统上，肱骨髓内钉固定术使用肱骨交锁髓内钉或恩德斯钉。在本研究中，我们分析了采用闭合顺行髓内钛弹性钉治疗肱骨干骨折（上三分之一和中三分之一）的愈合率、愈合时间、功能结果和并发症。对2014年8月至2016年6月期间在我们三级医疗中心接受顺行髓内钛弹性钉治疗的25例患者进行了回顾性分析。纳入研究的患者为骨骼成熟、男女皆有、肱骨干中上段闭合性急性骨折患者。25例（100%）骨折均愈合，平均愈合时间为14.98周（10 - 32周），无骨折不愈合情况。2例（8%）出现钉撞击，1例（4%）出现肩关节僵硬。22例（88%）功能结果优秀，2例（8%）中等，1例（4%）较差。男性17例，女性8例，平均年龄39.08岁（范围：18 - 65岁）。平均住院时间为3.84±2.30天。闭合顺行髓内钛弹性钉为成人肱骨干上段骨折的固定提供了一种安全可靠的方法。该方法除了能早期康复并缩短住院时间外，还能实现早期骨折愈合、高愈合率且并发症较少。
