Ingman A M, Waters D A
Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, South Australia.
J Bone Joint Surg Br. 1994 Jan;76(1):23-9.
We report our experience with a modified implant and a new technique for locked intramedullary nailing of the humerus in 41 patients. Locking was by cross-screws placed from lateral to medial in the proximal humerus, and anteroposteriorly in the distal humerus. Early in the series, 11 nails were inserted at the shoulder, but we found that rehabilitation was faster after retrograde nailing through the olecranon fossa, which was used for the other 30. We used a closed technique for 29 of the nailings. Of the 41 patients treated, 21 had acute fractures, five had nonunion, and 15 had pathological fractures. Secure fixation was obtained for comminuted and osteoporotic fractures in any part of the humeral shaft, which allowed the early use of crutches and walking frames. Two nails were locked at only one end, and one of these became the only failure of union after an acute fracture.
我们报告了41例患者采用改良型植入物和肱骨锁定髓内钉新技术的经验。锁定方式为在肱骨近端从外侧向内侧置入交叉螺钉，在肱骨远端前后置入。在该系列手术早期，11枚髓内钉经肩部置入，但我们发现经鹰嘴窝逆行置入髓内钉后康复更快，其余30例采用此方法。29例髓内钉置入采用闭合技术。41例接受治疗的患者中，21例为急性骨折，5例为骨不连，15例为病理性骨折。肱骨干任何部位的粉碎性骨折和骨质疏松性骨折均获得了牢固固定，这使得患者能够早期使用拐杖和步行架。2枚髓内钉仅在一端锁定，其中1例在急性骨折后成为唯一的骨不连失败病例。
