摘要
目的评价采用AO锁定加压钢板（LCP）治疗肱骨干骨折术后骨不连的疗效。方法2003年1月～2006年1月对23例24侧肱骨干骨折术后骨不连患者采用LCP内固定加自体骨移植及术后佩戴肩外展架的治疗方法。操作要点：臂外侧入路，首先保护好桡神经，清除骨不连部位的瘢痕组织，打通骨髓腔，骨膜做有限剥离。钢板应足够长，骨不连的两端至少各有4枚自锁螺钉固定，锁钉应穿过双侧骨皮质，自体松质骨植骨，术后患肢用肩外展架保护2～3个月。结果所有骨不连全部愈合，愈合时间3～6个月，平均4．2个月。2例术后出现桡神经牵拉性麻痹，经对症处理分别于术后3周、6周逐渐恢复。18例仍遗留不同程度肩关节功能障碍。结论LCP治疗肱骨干骨折术后骨不连的优点在于螺钉与钢板锁定为一体，不会出现单钉折断或钢板松动的情况，骨折治愈率高，是治疗肱骨干骨折术后骨不连的较好方法。
Objective To evaluate the treatment of nonunion of the humeral shaft with a locking compression plate （LCP） . Methods Twenty-three cases of nonunion of humeral shaft fracture from January 2003 to January 2006 were analyzed retrospectively. All the fractures were managed by open reduction, LCP fixation and cancellous bone graft, and the affected extremities were protected with shoulder abduction braces immediately after the operation. The key points of the operation were as follows： lateral approach, protection of the radial nerve, removal of the cicatrix, reopening of humeral canal, limited periosteum striping, appropriate length of LCP, at least 4 locking screws on either stump, double cortices penetrated with locking screws, cancellous bone graft and shoulder abduction brace protection for 2 - 3 months. Results All the fractures healed with a mean period of 4. 2 months （from 3 to 6 months）. Two cases showed temporary radial nerve palsy after the operation, which gradually recovered 3 and 6 weeks respectively after appropriate treatment. Shoulder functions were somewhat impaired in 18 cases. Conclusions Fixation by LCP with supplemental cancellous bone graft is a reliable and effective treatment for nonunion of humeral shaft fracture. The integrity of locking screws and plate prevents screw breakage and plate loosening so that the healing rate of humeral shaft nonunion is increased.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第11期1009-1011,共3页
Chinese Journal of Orthopaedic Trauma
关键词
肱骨骨折
骨不连
钢板
骨折固定术
内
Humeral fractare
Nonuion
Plate
Fracture fixation, internal
