【摘要】 [目的]分析钢板和髓内钉治疗肱骨干骨折的效果。[方法]选择75例肱骨干骨折钢板或髓内钉固定患者,统计肱骨干骨折类型,手术操作时间,手术中失血量及术后伤口引流量,术后并发症发生情况,伤侧肩关节和肘关节功能恢复及骨折愈合时间。对统计结果进行t检验或Kolmogorov-Smirnov检验。[结果]钢板和髓内钉可应用于各种类型肱骨干骨折固定,前者平均手术操作时间为162.11 min,后者为143.5 min,差异不显著;钢板固定术中平均出血量为541.73 ml,术后伤口平均引流量为130.4 ml,髓内钉组术中失血225.67 ml,术后伤口引流量为67.22 ml,两项指标在两种治疗方法之间存在显著差异;两种治疗方法术后骨折均愈合,钢板固定组愈合时间平均为13.58周,髓内钉固定组为12.97周,差异不显著;钢板固定组肩关节和肘关节功能评分平均为90.89分和89.69分,髓内钉固定组平均为89.70分和90.10分,两组肩关节和肘关节功能恢复没有明显差异;12例(26.67%)钢板固定患者术后出现桡神经损伤体征,1例(2.22%)发生感染,髓内钉固定组没有明显并发症发生。[结论]钢板和髓内钉均可用于固定各种类型肱骨干骨折。钢板固定易损伤桡神经,术中出血多,术后引流量大;髓内钉固定肱骨干骨折以闭合治疗为主,手术操作比较安全。两种治疗方法在手术操作时间、骨折愈合率和愈合时间及肩、肘关节功能恢复方面相近。更多还原

【Abstract】 [Objective] To analyze the treatment of humeral fracture fixed with the plate or the intramedullary nail.[Method] Seventy-five cases of humeral fractures fixed with the plate or intramedullary nail were observed.The type of humeral fractures,the amount of operative time,the amount of bleeding during operation and from the wound after operation,complications,the recovery of the shoulder and elbow function and the time of the union were caculated.The results were analyzed with t test and Kolmogorov-Smirnov test.[Result]All kinds of humeral fractures could be fixed with the plate or the intramedullary nail,and there was no difference in the average amount of operative time which was 162.11 minutes in plate group and 143.5 minutes in nail group.The average amount of bleeding during operation and the blood from the wound after operation were 541.73ml and 130.4ml in the plate group and 225.67 ml and 67.22 ml in the nail group,which had difference between two groups.All fractures united and the union time were 13.58 weeks in plate group and 12.97 weeks in nail group.The score of the recovered shoulder and elbow were 90.89 and 89.69 in the plate group,and 89.70 and 90.10 in the nail group,there were no difference between two groups.There were 12 cases(26.67%) injuried the radial nevers and 1 case(2.22%) infected in the plate group,and there was no complication in the nail group.[Conclusion]All kinds of humeral fractures were fixed with the plate or the intramedullary nail.The radial nerve might be injuried and the amount of bleeding during operation and after operation were more in the plate group.The operation in which the humeral fracture was fixed with the nail by closed manipulation is safer.The operative time,the rate of union,and the recovery of shoulder and elbow function are similar between two methods.更多还原