Rommens P M, Verbruggen J, Broos P L
Abteilung für Unfallchirurgie, Katholischen Universität Leuven.
Unfallchirurg. 1995 Mar;98(3):133-8.
Between August 1991 and December 1993, 48 fractures of the humeral shaft were treated operatively by retrograde interlocked nailing and followed up prospectively. The fractures were fresh in 39 patients and pathological in 6; in 3 the fracture had already been operated on. The Russell-Taylor nail was always inserted. In 1 of the 39 fresh fractures (2.6%) a postoperative palsy of the radial nerve was observed. In 3 cases (7.8%) comminution occurred at the fracture site. The comminution did not affect fracture healing. Consolidation was seen after an average of 13.7 weeks. In 2 patients a secondary intervention was necessary because of delayed fracture healing. After consolidation of the fractures, the shoulder function was excellent in 92.3% and elbow function excellent in 87.1% of cases. All 6 patients with pathological fractures were free of pain and had acceptable functioning of their stabilized upper arm. In 2 of the 3 fractures that had been operated on before nailing, pseudarthrosis developed. This was attributed to lack of interfragmentary compression. Retrograde nailing of the humeral shaft is a reliable procedure for fresh humeral shaft fractures and for pathological fractures. Small design changes are necessary to obtain a nail that can be used for the treatment of humeral shaft fractures with a lowered healing tendency.
1991年8月至1993年12月期间，对48例肱骨干骨折患者采用逆行交锁髓内钉进行手术治疗，并进行前瞻性随访。其中39例为新鲜骨折，6例为病理性骨折，3例骨折此前已接受过手术治疗。均采用Russell-Taylor髓内钉。39例新鲜骨折中有1例（2.6%）术后出现桡神经麻痹。3例（7.8%）骨折部位出现粉碎性骨折，但粉碎性骨折未影响骨折愈合。骨折平均在13.7周后愈合。2例患者因骨折愈合延迟需要二次干预。骨折愈合后，92.3%的患者肩部功能优良，87.1%的患者肘部功能优良。6例病理性骨折患者均无疼痛，稳定后的上臂功能可接受。在髓内钉固定前已接受过手术的3例骨折中，有2例发生骨不连，原因是缺乏骨折块间加压。肱骨干逆行髓内钉固定术对于新鲜肱骨干骨折和病理性骨折是一种可靠的手术方法。为获得一种可用于治疗愈合倾向较低的肱骨干骨折的髓内钉，有必要对其设计进行微小改进。
