Huang Ying-Cheng, Renn Jenn-Huei, Tarng Yih-Wen
Department of Orthopaedics, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd, Kaohsiung, 81346, Taiwan, Republic of China.
National Yang-Ming University, Taipei, Taiwan, Republic of China.
J Orthop Surg Res. 2018 Jan 15;13(1):10. doi: 10.1186/s13018-017-0704-y.
To investigate whether closed reduction and internal fixation (CRIF) with titanium elastic nails (TENs) is a viable alternative treatment in proximal radial fractures.
In Kaohsiung Veterans General Hospital, from November 2013 to April 2015, five adult male patients with forearm injuries (average age 43 years; range 35-64 years) were treated for proximal radial shaft fractures. CRIF with TENs for radial shaft fractures was performed in these five patients. Radiographs; range of motions; visual analog scale (VAS); quick disabilities of the arm, shoulder, and hand (Quick DASH) questionnaire; and time to union were evaluated in our study.
Mean follow-up period was 30 months (range 28-36 months). Average time of radius union was 7.3 months (range 6-10 months). Functional outcomes 1 year after operation revealed an average Quick DASH score of 7.92 (range 4.5-25), an average VAS of 1.5 (range 1-3), and average forearm supination and pronation of 69.2° (range 45°-75°) and 82.5° (range 80°-85°). No major complication was noted.
CRIF with TEN for adult proximal radial fractures is a method to avoid extensive exposure or nerve injury during ORIF, especially in multiple trauma patients who require short operative time, uremia patients with ipsilateral forearm AV shunt, severe soft tissue swelling due to direct muscle contusion or strong muscularity before surgery, extensive radial fracture, and those in pursuit of cosmetic outcomes.
探讨采用钛弹性髓内钉（TEN）进行闭合复位内固定（CRIF）治疗桡骨近端骨折是否是一种可行的替代治疗方法。
2013年11月至2015年4月，高雄荣民总医院对5例成年男性前臂损伤患者（平均年龄43岁；范围35 - 64岁）进行桡骨近端骨干骨折治疗。对这5例患者采用TEN进行桡骨干骨折的CRIF治疗。在本研究中评估了X线片、活动范围、视觉模拟评分（VAS）、手臂、肩部和手部快速残疾问卷（Quick DASH）以及骨折愈合时间。
平均随访期为30个月（范围28 - 36个月）。桡骨平均愈合时间为7.3个月（范围6 - 10个月）。术后1年的功能结果显示，Quick DASH平均评分为7.92（范围4.5 - 25），VAS平均评分为1.5（范围1 - 3），前臂平均旋后和旋前角度分别为69.2°（范围45° - 75°）和82.5°（范围80° - 85°）。未发现重大并发症。
对于成人桡骨近端骨折，采用TEN进行CRIF是一种在切开复位内固定（ORIF）过程中避免广泛暴露或神经损伤的方法，尤其适用于需要短手术时间的多发伤患者、同侧前臂有动静脉分流的尿毒症患者、术前因直接肌肉挫伤或肌肉发达导致严重软组织肿胀、广泛桡骨骨折以及追求美容效果的患者。
