两种内固定方法治疗肱骨干骨折的临床比较研究

摘要

目的 比较限制接触动力加压钢板内固定、交锁髓内钉内固定治疗肱骨干骨折的疗效,选择合适的内固定.方法 肱骨干骨折76例,采用限制接触动力加压钢板内固定治疗(LC-DCP组)44例;髓内钉内固定治疗(LIN组)32例.对两组术中情况、骨折愈合情况及并发症发生情况进行比较.结果 76例患者术后获得6~24个月随访(平均13.2个月).LC-DCP组手术时间、手术切口均较LIN组长,而骨折愈合率明显高于LIN组(P均<0.05).LC-DCP组桡神经损伤的并发症发生率明显高于LIN组,而肩关节功能障碍的并发症发生率明显低于LIN组(P<0.05).两组均未出现感染病例.结论 肱骨粉碎骨折、多段骨折适合髓内钉内固定,简单骨折、合并桡神经损伤的骨折适合限制接触动力加压钢板内固定.%Objective A comparative Study had been carried out on clinical effect between limited contact - dynamic compression plates ( LC - DCP ) fixation and interlocking nail fixaton in treatment of humeral shaft fractures. Methods Seventy six cases of humeral shaft fractures had heen treated hy LC - DCP fixation or interlocking nail fixation including 44 cases by LC - DCP and 32 cases by LIM. The intraoperafive conditions , fracture healing and complications were compared. Results All cases were followed up for 6 to 24 months , with an average of 13. 2 months.There was significant difference among operating time, incision length, radial nerve injury, shoulder dysfunction and rate of fracture healing ( P ＜0. 05 ). None of these cases had incision infection. Conclusion The interlocking nail fixation is suitahle for treatment of cases of comminuted fractures and multiple fractures of humeral shaft , and LC - DCP fixation is suitable for treatment of cases of simple fractures and humeral shaft fractures with radial nerve injury.