Wu Min, Guan Jianzhong, Xiao Yuzhou, Dai Xiusong, Li Yonghao, Bao Zhengqi, Wang Zhaodong, Chen Xiaotian
Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Laboratory of Tissue and Transplant in Anhui Province, Bengbu Anhui, 233003,
Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Laboratory of Tissue and Transplant in Anhui Province, Bengbu Anhui, 233003, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Jan 15;31(1):1-4. doi: 10.7507/1002-1892.201610021.
To assess the effectiveness of locking compress plate and extra cortical bone bridge fixation for treating atrophic humeral nonunion.
Seventeen patients with atrophic humeral nonuninon were treated with locking compress plate and extra cortical bone bridge fixation between November 2006 and June 2015. Of 17 cases, 11 were male, 6 were female, aged 24-63 years (mean, 38.2 years). Fracture located at the left side in 9 cases and at the right side in 8 cases. The mechanism of injury was traffic accident in 13 cases, falling from height in 3 cases, and heavy pound injury in 1 case. The patients underwent surgery for 1 time in 7 cases, for 2 times in 5 cases, for 3 times in 4 cases, and for 4 times in 1 case. The time from fracture to hospitalization was 10-76 months (mean, 22.6 months). The shoulder function was evaluated by Neer score, and elbow function by Mayo score.
All incisions healed by first intention. Two cases had transient radial nerve symptoms of numbness. All patients were followed up 27.3 months on average (range, 15-60 months). Radiographic examination showed signs of bone remodeling at 6-8 weeks after operation, and formation of extra cortical bone bridge. All of them achieved bone union within 10 to 41 weeks (mean, 17.6 weeks). At last follow-up, the average Neer score was 83.36 (range, 72-96); and the shoulder function was excellent in 10 cases, good in 5, and fair in 2 with an excellent and good rate of 88.24%. And the average Mayo score was 86.52 (range, 68-100); and the elbow function was excellent in 11 cases, good in 3, and fair in 3 with an excellent and good rate of 82.35%.
The bone bridging could effectively form by extra cortical grafting technique. Atrophic humeral nonunions can be successfully treated with locking compress plate and extra cortical bone bridge fixation.
评估锁定加压钢板及骨皮质外骨桥固定治疗萎缩性肱骨骨不连的有效性。
2006年11月至2015年6月，对17例萎缩性肱骨骨不连患者采用锁定加压钢板及骨皮质外骨桥固定治疗。17例中，男11例，女6例，年龄24 - 63岁（平均38.2岁）。骨折位于左侧9例，右侧8例。致伤机制：交通事故13例，高处坠落3例，重物砸伤1例。手术次数：1次7例，2次5例，3次4例，4次1例。骨折至住院时间10 - 76个月（平均22.6个月）。采用Neer评分评估肩关节功能，Mayo评分评估肘关节功能。
所有切口均一期愈合。2例出现短暂性桡神经麻木症状。所有患者平均随访27.3个月（范围15 - 60个月）。影像学检查显示术后6 - 8周有骨重塑迹象及骨皮质外骨桥形成。所有患者均在10至41周（平均17.6周）内实现骨愈合。末次随访时，Neer评分平均83.36（范围72 - 96）；肩关节功能优10例，良5例，可2例，优良率88.24%。Mayo评分平均86.52（范围68 - 100）；肘关节功能优11例，良3例，可3例，优良率82.35%。
通过骨皮质外植骨技术可有效形成骨桥。锁定加压钢板及骨皮质外骨桥固定可成功治疗萎缩性肱骨骨不连。
