Heim D, Herkert F, Hess P, Regazzoni P
Department of Surgery, University Hospital, Basel, Switzerland.
J Trauma. 1993 Aug;35(2):226-32.
One hundred twenty seven patients with fractures of the humeral shaft were treated by open reduction and internal fixation using 4.5-mm dynamic compression plates (DCP). Seventy one osteosyntheses were performed primarily, 36 following attempted closed reduction, and 20 secondarily after a failed conservative treatment of about 8 weeks. A primary radial nerve palsy was present in 19 patients, and appeared subsequently in four additional patients. One hundred two of the 127 patients could be clinically and radiologically examined 1 year after internal fixation: 89 patients (87.3%) had excellent or good results with full functional recovery. Thirteen patients (12.7%) showed a limited range of motion of either the shoulder or elbow or both. This was mostly because of other fractures of the same limb or persistent neurologic impairment. We observed two transitory postoperative nerve palsies, five early failures of internal fixation because of technical errors, two pseudarthroses and four postoperative infections, which healed with one exception by suction drainage and early removal of the plate. We conclude that a correct plate fixation of humeral shaft fractures in a selected group of patients represents an alternative to conservative treatment with the advantage of greater patient comfort.
127例肱骨干骨折患者采用4.5mm动力加压钢板（DCP）切开复位内固定治疗。其中71例为一期骨合成，36例为试行闭合复位后进行，20例为约8周保守治疗失败后二期进行。19例患者存在原发性桡神经麻痹，另有4例随后出现。127例患者中有102例在内固定术后1年接受了临床和影像学检查：89例患者（87.3%）功能完全恢复，结果为优或良。13例患者（12.7%）出现肩部或肘部或两者活动范围受限。这主要是由于同一肢体的其他骨折或持续性神经损伤。我们观察到2例术后短暂性神经麻痹，5例因技术失误导致早期内固定失败，2例假关节形成，4例术后感染，除1例通过吸引引流和早期取出钢板治愈外，其余均愈合。我们得出结论，在选定的一组患者中，正确的钢板固定肱骨干骨折是保守治疗的一种替代方法，其优点是患者舒适度更高。
