[1]李伟元△ 孙卫强 刘坤 王晓波 徐立民 杨晶 刘波.手法复位结合微创改良入路弹性髓内钉逆行内固定治疗成人肱骨干骨折[J].中国中医骨伤科杂志,2021,29(01):49-53.
　LI Weiyuan SUN Weiqiang LIU Kun WANG Xiaobo XU Limin YANG Jing LIU Bo.The Treatment of Humeral Shaft Fracture in Adults by RetrogradeInternal Fixation with Elastic Intramedullary Nail via ManualReduction and Improved Approach with Minimally Invasion[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(01):49-53.
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手法复位结合微创改良入路弹性髓内钉逆行内固定治疗成人肱骨干骨折()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年01期
页码:
49-53
栏目:
临床论著
出版日期:
2021-01-15

文章信息/Info

Title:
The Treatment of Humeral Shaft Fracture in Adults by RetrogradeInternal Fixation with Elastic Intramedullary Nail via ManualReduction and Improved Approach with Minimally Invasion
文章编号:
1005-0205(2021)01-0049-05
作者:
李伟元1△ 孙卫强1 刘坤1 王晓波1 徐立民1 杨晶1 刘波1
Author(s):
LI Weiyuan1△ SUN Weiqiang1 LIU Kun1 WANG Xiaobo1 XU Limin1 YANG Jing1 LIU Bo1
1Department of Traumatology,Wendeng Osteological Hospital of Shandong Province,Weihai 264400,Shandong China.
关键词:
肱骨干骨折;  弹性髓内钉;  手法复位;  改良入路;  逆行
Keywords:
humeral shaft fracture;  elastic intramedullary nail;  manual reduction;  improved approach;  retrograde
分类号:
R683.41
文献标志码:
A
摘要:
目的:探讨手法复位结合微创改良入路弹性髓内钉逆行内固定治疗成人肱骨干骨折的方法,并评价其疗效。方法:回顾性分析从2012年1 月至2019 年10月,以手法复位结合微创改良入路弹性髓内钉逆行内固定治疗62例成人肱骨干骨折患者的临床资料。其中男 35例,女27例; 年龄18～79岁,平均 45.2岁。患者均应用手法复位结合微创改良入路弹性髓内钉经皮逆行穿针内固定治疗,术后观察患侧肩疼痛、功能、运动范围、解剖复位情况,观察患侧肘关节疼痛、运动功能、稳定性、日常活动等情况。末次随访时采用疼痛视觉模拟评分(VAS)评估患臂疼痛情况,采用Neer评分评定患侧肩关节疗效,采用Mayo评分评价患侧肘关节总体功能。结果:62例患者均顺利完成手术,手术时间12～74 min,平均 34 min; 出血量 10～45 mL,平均 29 mL。62 例均获得随访10～48个月,平均19.5个月。患者术后均无神经血管损伤、骨不连、关节僵硬等情况发生。骨折均获得愈合,愈合时间为 9～28周,平均20.3 周。末次随访时VAS 评分为0～3 分,平均 0.7分; Neer 评分为 85～100 分,平均 94 分; Mayo评分为90～100 分,平均 97 分。疗效评定为优 58 例,良 4 例,优良率 100%。结论:手法复位结合微创改良入路弹性髓内钉经皮逆行穿针内固定治疗成人肱骨干骨折疗效满意,该方法具有微创、易于操作,出血少、固定可靠、并发症少,无需二次住院取内固定,无明显手术疤痕等优点。
Abstract:
To explore the method of retrograde internal fixation with elastic intramedullary nail via improved approach with minimally invasion for the treatment of adult humeral shaft fracture,and to evaluate its curative effect.Methods:62 adult patients of humeral shaft fracture were treated by retrograde internal fixation with elastic intramedullary nail through manual reduction and improved approach with minimally invasion from January 2012 to October 2019.The clinical data were analyzed retrospectively.There were 35 males and 27 females,with an average age of 45.2 years old(18-79 years old).The pain,function,range of motion and anatomical reduction of the affected shoulder were observed.At the same time,the pain,movement function,stability and daily activities of the affected elbow joint were observed.At the last follow-up,visual analogue scale(VAS)was used to evaluate the pain of the affected arm,Neer score was used to evaluate the effected shoulder joint,and Mayo score was used to evaluate the overall function of the elbow joint.Results:All of the 62 patients completed the operation successfully,the average operation time was 34 min(12-74 min),and the average bleeding volume was 29 mL(10-45 mL).62 cases were followed up for 10-48 months,with an average of 19.5 months.There was no neurovascular injury,nonunion and joint stiffness after operation.All fractures healed very well,the average healing time was 20.3 weeks(9-28 weeks).At the last follow-up,VAS score was 0-3 with average of 0.7,and the Neer score was 85-100 with an average of 94,and the Mayo score was 90-100 with an average of 97.The excellent rate was 100% with 58 cases of excellent and 4 cases of good.Conclusion:The treatment of adult humeral shaft fracture by retrograde internal fixation with elastic intramedullary nail through manual reduction and improved approach with minimally invasion is satisfied.This method has the advantages of minimally invasion,easy operation,less bleeding,reliable fixation,less complications,no need for secondary hospitalization to remove the nails,no obvious surgical scar.

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备注/Memo

备注/Memo:
1山东省文登整骨医院四肢创伤科(山东 威海,264400)
△通信作者 E-mail:hilwy@126.com
更新日期/Last Update: 2021-01-15