摘要
目的探讨弹性髓内钉内固定手术治疗儿童肱骨近端骨折的临床疗效。方法回顾性分析自2014-02—2017-02采用弹性髓内钉内固定手术治疗的27例儿童肱骨近端骨折,术中采用经内、外髁双侧入路或外侧髁单侧入路置入髓内钉。结果 27例均获得随访,随访时间平均12(9~18)个月。末次随访时影像学资料显示骨折部位骨痂生长良好,未出现弹性髓内钉断裂滑脱、骨折延迟愈合或不愈合、切口疼痛、血管损伤、尺神经损伤等并发症。末次随访时Constant-Murley肩关节功能评分平均92.6(78~98)分,其中优23例,良3例,可1例;患肢前屈上举平均162.5°(145°~175°),外展上举平均173.2°(145°~180°),中立位外旋平均41.2°(38°~45°),中立位内旋平均59.8°(50°~70°)。结论采用弹性髓内钉内固定手术治疗儿童肱骨近端骨折可有效减少创伤,术中损伤小、固定效果稳定,术后并发症较少、患肢功能恢复良好,可作为治疗儿童肱骨近端骨折的有效方法,值得临床借鉴与推广。
Objective To investigate the clinical effect of elastic intramedullary nail fixation in the treatment of proximal humeral fracture in children. Methods Twenty-seven children with proximal humeral fractures treated with elastic intramedullary nail fixation form February 2014 to February 2017 were analyzed retrospectively. Intramedullary nails were placed through bilateral approach of internal and external condyles or unilateral approach of lateral condyles. Results All 27 cases were followed up for an average of 12(9-18) months. The imaging data showed that the callus grew well at the fracture site during the last follow-up. There were no complications such as fracture and slippage of elastic intramedullary nail,delayed or non union of fracture, incision pain, vascular injury, ulnar nerve injury. At the last follow-up, the mean constant Murley shoulder joint function score was 92.6(78-98), excellent in 23 cases, good 3 cases, fair 1 case;the average of the affected limb was 162.5°(145°-175°), abduction up 173.2°(145°-180°), neutral external rotation 41.2°(38°-45°), neutral internal rotation 59.8°(50°-70°). Conclusion The treatment of proximal humeral fractures in children with elastic intramedullary nail can effectively reduce the trauma, with small intraoperative injury, stable fixation effect, less postoperative complications and good functional recovery of the affected limb. It can be used as an effective method for treating humeral fractures in children, which is worthy of clinical reference and promotion.
出处
《中国骨与关节损伤杂志》
2020年第7期694-696,共3页
Chinese Journal of Bone and Joint Injury
基金
国家自然科学基金(81602867)
湖北省自然科学基金(2018CFB524)
湖北省教育厅科学研究计划指导性项目(B2018110)。
关键词
肱骨近端骨折
儿童
弹性髓内钉
内固定
Proximal humeral fracture
Children
Elastic intramedullary nail
Internal fixation
