实用医学杂志 ›› 2023, Vol. 39 ›› Issue (8): 980-984.doi: 10.3969/j.issn.1006⁃5725.2023.08.011

• 临床研究 • 上一篇    下一篇

Multiloc 钉与钢板治疗肱骨干骨折术后非感染性骨不连的疗效 

李祖涛1 翁友林2 蔡昱1 徐江波1 车立新1 孙俊刚1    

  1. 1 新疆维吾尔自治区人民医院骨科中心(乌鲁木齐 830011);2 新疆医科大学研究生学院(乌鲁木齐 830000) 
  • 出版日期:2023-04-25 发布日期:2023-04-25
  • 通讯作者: 孙俊刚 E⁃mail:710999438@qq.com
  • 基金资助:
    新疆维吾尔自治区自然科学基金(编号:2019D01C106)

Comparison of Multiloc nail and steel plate in the treatment of non⁃infective nonunion after humeral shaft fracture

LI Zutao*,WENG Youlin,CAI Yu,XU Jiangbo,CHE Lixin,SUN Jungang.   

  1. Department of Orthope⁃ dics,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830011,China

  • Online:2023-04-25 Published:2023-04-25
  • Contact: SUN Jungang E⁃mail:710999438@qq.com

摘要:

目的 对比 Multiloc 髓内钉与钢板治疗肱骨干骨折术后非感染性骨不连的疗效。方法 回顾性分析自 2019 年 5 月至 2021 年 5 月新疆维吾尔自治区人民医院骨科中心诊治的肱骨干骨折内固 定术后发生非感染性骨不连患者资料 43 例,男 23 例,女 20 例;年龄 34 ~ 77 岁,平均 42.1 岁。所有患 者根据内固定方式分为:Multiloc 髓内钉组 22 例,钢板组 21 例;两组患者内固定术后均联合自体髂骨植骨治疗。两组患者术前一般资料对比差异无统计学意义(P > 0.05),具有可比性;通过对比两组患者 手术时间、术中出血量、骨折愈合时间、Mayo 肘关节评分、Constant⁃Murley 肩关节功能评分及视觉疼痛 模拟评分(VAS)评估等指标治疗效果。结果 Multiloc 髓内钉组术中出血量、骨折愈合时间低于钢板 组,Mayo 肘关节评分评分高于钢板组,差异均有统计学意义(P < 0.05);手术时间、Constant⁃Murley 评 分及 VAS 评分两组对比差异均无统计学意义(P > 0.05)。两组患者术后各有 1 例桡神经损伤,随访 3 个月后恢复;所有患者术后获 12 ~ 24 个月(平均 16.8 个月)随访,末次随访时两组患者均无术后感 染、骨折不愈合、神经损伤等并发症发生,所有患者骨不连在随访期间内均获得骨性愈合。结论 与钢板内固定相比,Multiloc 髓内钉治疗肱骨干骨折术后非感染性骨不连可以减少术中出血量、降低骨折愈合时间、提高肘关节功能,把握合适的适应证的前提下可以作为临床治疗肱骨干骨折术后非 感染性骨不连的方案。

关键词: Multiloc 髓内钉, 钢板, 肱骨骨折, 骨不连, 内固定术

Abstract:

Objective To evaluate the efficacy of Multiloc intramedullary nail and plate in the treatment of postoperative non⁃infectious nonunion of humeral shaft fracture. Methods The data of 43 patients with non⁃ infective nonunion after internal fixation of humeral shaft fracture treated by the Orthopaedic Center of Xinjiang Uygur Autonomous region people′s Hospital from May 2019 to May 2021,including 23 males and 20 females, ranging in age from 34 to 77 years,with an average of 42.1 years,were analyzed retrospectively. According to the mode of internal fixation,all patients were divided into two groups:Multiloc intramedullary nail group(n = 22) and steel plate group(n = 21). The treatment effect was evaluated by comparing the operation time,intraoperative blood loss,fracture healing time,Mayo elbow score,Constant⁃Murley shoulder function score and visual pain sim⁃ ulation score between the two groups. Results The intraoperative blood loss and fracture healing time in the Multi⁃ loc intramedullary nail group were lower than those in the plate group,and the Mayo elbow score was higher than that in the plate group,but there was no significant difference in operation time,Constant⁃Murley score and VAS score between the two groups. There was one case of radial nerve injury in each of the two groups,which recovered after 3 months of follow⁃up,and all patients were followed up for 12 to 24 months(mean 16.8 months). At the last follow⁃up,there were no postoperative infection,fracture nonunion,nerve injury and other complications in both groups. all patients with nonunion healed during the follow⁃up period. Conclusion Compared with plate internal fixation,Multiloc intramedullary nail in the treatment of non⁃infectious nonunion of humeral shaft fracture can reduce intraoperative blood loss,shorten fracture healing time and improve elbow joint function. Under the premise of appropriate indications,it can be used as one of the clinical methods for the treatment of non ⁃infectious non⁃ union of humeral shaft fracture.

Key words:

multiloc intramedullary nail, locking plate, humeral fracture, nonunion, internal fixation