闭合复位弹性髓内钉内固定治疗青少年肱骨干骨折的临床研究

摘要

Objective To study the clinical effect of closed reduction and internal fixation with elastic intramedullary nail in the treatment of adolescents with humeral shaft fractures.Methods 78 adolescents with humeral shaft fractures admitted into our hospital from May,2010 to May,2011 were selected as study objects and were randomized into an observation group and a control group,39 cases for each group.The observation group were treated with closed reduction and internal fixation with elastic intramedullary nail and the control group conventional plate and screw fixation.The intraoperative bleeding volume,incision length,postoperative fracture healing time,operation time,and length of hospital stay of the two groups were recorded.The degree of postoperative pain on shoulder joint,and the excellent rate of fracture healing were compared between these two groups.Results The intraoperative bleeding volume was (53.69±18.53) ml,the incision length (2.51±0.53) cm,the postoperative fracture healing time (6.10±1.52) weeks,the operation time (60.36±11.59) days,and the length of hospital stay (8.31±2.64) days in the observation group,which were better those in the control group (P＜0.05).The incidence of severe pain on shoulder joint after operation was lower in the observation group than in the control group (2.56％ vs.20.51％,P＜0.05).The excellent rate of fracture healing was higher in the observation group than that in the control group (94.87％ vs.76.92％,P＜0.05).Conclusions Closed reduction and internal fixation with elastic intramedullary nail in the treatment of adolescents with humeral shaft fractures is minimally invasive,causes mild postoperative pain on shoulder joint,and can shorten postoperative fracture healing time,operation time,and hospitalization time and increase the excellent rate of fracture healing,so it is clinically feasible.%目的 探讨闭合复位弹性髓内钉内固定治疗青少年肱骨干骨折的临床研究.方法 选取本院2010年5月至2011年5月收治的78例青少年肱骨干骨折患者为研究对象,采用抽签方式,随机分为观察组与对照组,每组39例.观察组给予闭合复位弹性髓内钉内固定治疗,对照组给予普通钢板螺钉固定治疗,记录两组术中出血量、手术切口长度、术后骨折愈合时间、手术时间及住院时间,并比较术后肩关节功能疼痛程度及骨折愈合优良率.结果 观察组术中出血量(53.69±18.53) ml、手术切口长度(2.51±0.53) cm、术后骨折愈合时间(6.10±1.52)周、手术时间(60.36±11.59)d及住院时间(8.31±2.64)d均优于对照组,差异有统计学意义(P＜0.05).观察组术后肩关节中重度疼痛发生率(2.56％)低于对照组(20.51％),差异有统计学意义(P＜0.05).观察组骨折愈合优良率(94.87％)高于对照组(76.92％),差异有统计学意义(P＜0.05).结论 闭合复位弹性髓内钉内固定治疗青少年肱骨干骨折创伤小,术后肩关节疼痛程度低,可缩短术后骨折愈合时间、手术时间及住院时间,提高骨折愈合优良率,临床应用可行.