摘要
目的探讨闭合复位交锁髓内钉治疗肱骨外科颈骨折的临床疗效。方法自2012年1月至2014年9月，采用闭合复位交锁髓内钉治疗肱骨外科颈骨折患者22例。按Neer分型均为二部分骨折；按传统分类法：外展型2例，内收型12例，粉碎型8例。合并同侧肱骨干中段骨折2例，桡骨远端骨折2例，伴有高血压或糖尿病11例。均为闭合性骨折，手术方法均采用闭合复位，2例合并肱骨干中段骨折的选择长钉固定，其余均选择短钉固定，术后早期功能锻炼。结果本组22例手术患者均获得6～12个月的随访，平均8个月，未发生切口感染、神经血管损伤及内固定松动。随访内容包括骨折愈合及关节功能恢复情况，所有患者均获骨性愈合，时间为6～12周，平均8周，按照Neer肩关节功能评分标准评定：优12例，良7例，可3例；优良率86％。结论闭合复位交锁髓内钉内固定治疗移位的肱骨外科颈骨折，具有手术创伤小及内固定可靠的优点，特别适合老年肱骨近端两部分外科颈骨折。
Objective To investigate the clinical outcomes of treating humeral surgical neck fractures with closed reduction and interlocking intramedullary nail fixation. Methods From January 2012 to September 2014, 22 cases of humeral surgical neck fractures underwent closed reduction and interlocking intramedullary nail fixation. According to Neer classification, all 22 cases were two part fractures. According to the traditional classifications, there were 2 cases of abduction type, 12 cases of adduction type, and 8 cases of comminuted fractures. Two cases had accompanying ipsilateral humeral shaft fractures, while another 2 cases had distal radius fractures as well. Concomitant diseases such as hypertension or diabetes existed in 11 cases. All cases were closed fractures and were treated with closed reduction and internal fixation with short intramedullary nails except the 2 cases with humeral shaft fracture with long intramedullary nails. All cases underwent early postoperative functional exercise. Results All 22 patients were follow-up for 6 to 12 months, with an average of 8 months. There were no wound infection, no nerve or blood vessel injury, nor internal f＇ixation loosening. Fracture healing and joint function were evaluated during follow-up. Bone union was achieved in all the patients, with healing time ranging from 6 to 12 weeks, an average of 8 weeks. According to Neer shoulder function scoring system, the results were graded as excellent in 12 cases, good in 7 cases, and fair in 3 cases. The overall excellent and good rate was 86%. Conclusion Closed reduction and interlocking intramedullary nail fixation has advantages such as being minimally invasive and reliable fixation in treating humeral surgical neck fractures with displacement. It is especially suitable for two-part proximal humeral surgical neck fractures in elderly patients.
出处
《中华手外科杂志》
CSCD
北大核心
2015年第6期404-406,共3页
Chinese Journal of Hand Surgery
关键词
肩骨折
骨折固定术
髓内
外科手术
Shoulder fractures
Fracture fixation,intramedullary
Surgical procedures, operative
