锁定加压钢板微创治疗肱骨干骨折（钢板内固定）术后失效11例

摘要

Objective To investigate the clinical effect of the locking compression plate (LCP) for the minimally invasive treatment of humeral shaft fracture failure. Methods From April 2009 to January 2011 11 postoperative failure cases of humeral shaft fracture with internal fixation were treated by LCP replacement, the original fixation were removed, autologous bone were transplanted to the defect. Results 11 cases were followed up for 12~25 months (average 17 months), all fractures healed, the healing time was 3~7 months (average 4.5 months). according to standard of Mayo score evaluation, The elbow joint function was: excellent in 7 cases, good in 3 cases, moderate in1 case, the excellent and good rate was 90.9%. According to standard of Neer score of shoulder joint function evaluation: excellent in 7 cases, good in 4 cases, the excellent and good rate was 100%. No fixation failure, plate and screw loosening, bending or fracture, no nerve, vascular injury occurred. Conclusion For the postoperative failure of humeral shaft fractures plate fixation, the invasive treatment, LCP, combined with one stage bone grafting when necessary, has advantages of high rate of fracture healing, and good functional recovery.%目的：探讨锁定加压钢板（locking compression plate, LCP）微创治疗肱骨干骨折钢板内固定术后失效的临床效果。方法2009年4月-2011年1月收治肱骨干骨折术后内固定失效患者11例，均采用LCP置入，原内固定物取出，骨折端有缺损者行自体骨植骨。结果11例术后获12～25个月（平均17个月）随访，骨折全部愈合，愈合时间3~7个月（平均4.5个月）。肘关节功能按Mayo评分标准评定：优7例，良3例，可1例，优良率90.9%。肩关节功能按Neer评分标准评定：优7例，良4例，优良率100%。无钢板螺钉松动、弯曲及断裂等内固定失效的发生，无神经、血管损伤。结论对于肱骨干骨折钢板内固定术后失效的患者，采用LCP微创治疗，必要时一期植骨，具有骨折愈合率高、功能恢复好等优点。