Hems T E, Bhullar T P
Trauma Service, John Radcliffe Hospital, Oxford, UK.
Injury. 1996 Sep;27(7):485-9. doi: 10.1016/0020-1383(96)00056-3.
Forty-three patients with fractures of the humeral shaft were treated by locked intermedullary nailing, using the Russell-Taylor nailing system. Overall there were few technical problems with nail insertion. Additional fracture comminution occurred in five patients but affected stability in only one case. Twenty-six nails were inserted into 22 patients with pathological fractures. The objective of fracture stabilization and pain relief for the remaining life-span of the patient was achieved in all but one case. Out of 21 non-pathological fractures, seven had failed to unite at 8 months (33 per cent). Furthermore, five of the 17 fractures nailed soon after injury (29 per cent) went on to non-union. Four of 15 patients reviewed clinically had poor or unsatisfactory shoulder function. These results suggest that interlocking nailing should be used with caution in the management of non-pathological fractures.
43例肱骨干骨折患者采用罗素 - 泰勒髓内钉系统进行锁定髓内钉治疗。总体而言，钉子插入时技术问题较少。5例患者出现额外的骨折粉碎，但仅1例影响稳定性。22例病理性骨折患者共插入26枚钉子。除1例患者外，其余患者均在其剩余寿命中实现了骨折稳定和疼痛缓解的目标。21例非病理性骨折中，7例在8个月时未愈合（33%）。此外，受伤后不久进行髓内钉固定的17例骨折中有5例（29%）发生骨不连。临床复查的15例患者中有4例肩部功能较差或不理想。这些结果表明，在非病理性骨折的治疗中应谨慎使用交锁髓内钉。
