Yuan Yu-Fei, Miao Jie
Department of Orthopedics, Handan Center Hospital, Handan 056001, Hebei Province, China.
World J Orthop. 2025 Apr 18;16(4):101392. doi: 10.5312/wjo.v16.i4.101392.
Operative management of humeral shaft fractures demonstrates superior early functional recovery (6-month Disabilities of the Arm, Shoulder, and Hand scores) and significantly lower nonunion rates (63.9% reduction) compared to functional bracing, particularly in complex cases, while conservative treatment remains viable for low-demand patients. Surgical techniques, including open reduction internal fixation, intramedullary nailing, and minimally invasive plate osteosynthesis, offer trade-offs between anatomic precision and complication risks (, radial nerve injury rotator cuff damage), with over 90% of radial nerve injuries resolving spontaneously. Ultrasound-guided diagnosis (89% sensitivity, 95% specificity) optimizes decision-making for nerve entrapment. Individualized treatment selection, prioritizing fracture complexity and patient needs, is critical to balance accelerated rehabilitation with minimized complications.
与功能支具相比，肱骨干骨折的手术治疗显示出更好的早期功能恢复（6个月时的手臂、肩部和手部残疾评分），骨不连发生率显著降低（降低63.9%），尤其是在复杂病例中，而保守治疗对于需求较低的患者仍然可行。手术技术，包括切开复位内固定、髓内钉固定和微创钢板接骨术，在解剖精度和并发症风险（如桡神经损伤、肩袖损伤）之间存在权衡，超过90%的桡神经损伤可自发恢复。超声引导诊断（敏感性89%，特异性95%）可优化神经卡压的决策。根据骨折复杂性和患者需求进行个体化治疗选择，对于平衡加速康复与最小化并发症至关重要。
