中国骨伤
中國骨傷
중국골상
CHINA JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
2015年
5期
469-471
,共3页
桡神经%肱骨骨折%骨折固定术,内%外科手术
橈神經%肱骨骨摺%骨摺固定術,內%外科手術
뇨신경%굉골골절%골절고정술,내%외과수술
Radial nerve%Humeral fractures%Fracure fixation,internal%Surgical procedures,operative
目的：探讨在肱骨中下段骨折钢板内固定术中将桡神经内置的方法及疗效。方法：自2010年1月至2013年12月采用桡神经内置钢板内固定术治疗31例肱骨中下段骨折患者，男18例，女13例；年龄26～58岁，平均37岁；受伤至手术时间1～8 d，平均4.5 d。按AO骨折分型：A1型7例，A2型3例，A3型6例，B1型2例，B2型4例，B3型2例，C1例4例，C2型3例。患者术前均无桡神经损伤征象。采用美国骨科协会提出的DASH量表进行疗效评定，0表示上肢功能正常，1～100表示上肢功能有不同程度的损伤。结果：31例患者术后未发生与手术相关并发症，无神经损伤与伤口感染。31例患者术后获随访，时间8～15个月，平均11个月。上肢功能按DASH上肢功能量表评定，患者伤后评分76.2±11.8，末次随访评分8.2±7.4，术后随访评分与伤后评分比较差异有统计学意义（t=9.717，P<0.01），上肢功能恢复满意。结论：在肱骨中下段骨折钢板内固定术中将桡神经内置可有效避免医源性桡神经损伤。
目的：探討在肱骨中下段骨摺鋼闆內固定術中將橈神經內置的方法及療效。方法：自2010年1月至2013年12月採用橈神經內置鋼闆內固定術治療31例肱骨中下段骨摺患者，男18例，女13例；年齡26～58歲，平均37歲；受傷至手術時間1～8 d，平均4.5 d。按AO骨摺分型：A1型7例，A2型3例，A3型6例，B1型2例，B2型4例，B3型2例，C1例4例，C2型3例。患者術前均無橈神經損傷徵象。採用美國骨科協會提齣的DASH量錶進行療效評定，0錶示上肢功能正常，1～100錶示上肢功能有不同程度的損傷。結果：31例患者術後未髮生與手術相關併髮癥，無神經損傷與傷口感染。31例患者術後穫隨訪，時間8～15箇月，平均11箇月。上肢功能按DASH上肢功能量錶評定，患者傷後評分76.2±11.8，末次隨訪評分8.2±7.4，術後隨訪評分與傷後評分比較差異有統計學意義（t=9.717，P<0.01），上肢功能恢複滿意。結論：在肱骨中下段骨摺鋼闆內固定術中將橈神經內置可有效避免醫源性橈神經損傷。
목적：탐토재굉골중하단골절강판내고정술중장뇨신경내치적방법급료효。방법：자2010년1월지2013년12월채용뇨신경내치강판내고정술치료31례굉골중하단골절환자，남18례，녀13례；년령26～58세，평균37세；수상지수술시간1～8 d，평균4.5 d。안AO골절분형：A1형7례，A2형3례，A3형6례，B1형2례，B2형4례，B3형2례，C1례4례，C2형3례。환자술전균무뇨신경손상정상。채용미국골과협회제출적DASH량표진행료효평정，0표시상지공능정상，1～100표시상지공능유불동정도적손상。결과：31례환자술후미발생여수술상관병발증，무신경손상여상구감염。31례환자술후획수방，시간8～15개월，평균11개월。상지공능안DASH상지공능량표평정，환자상후평분76.2±11.8，말차수방평분8.2±7.4，술후수방평분여상후평분비교차이유통계학의의（t=9.717，P<0.01），상지공능회복만의。결론：재굉골중하단골절강판내고정술중장뇨신경내치가유효피면의원성뇨신경손상。
Objective:To investigate the method of medial transposition of the radial nerve in plate fixation of lower seg?ment fracture of humerus. Methods:From January 2010 to December 2013,31 patients with medial transposition of the radi?al nerve in plate fixation of lower segment fracture of humerus,including 18 males and 13 females ranging in age from 26 to 58 years old with a mean of 37 years old. The time between injury and operation was 1 to 8 days with an average of 4.5 days. According to AO classification,7 fractures were type A1,3 fractures were type A2,6 fractures were type A3,2 fractures were type B1,4 fractures were type B2,2 fractures were type B3,4 fractures were type C1,3 fractures were type C2. No patients had any signs of radial nerve injury. The results were evaluated with DASH(disability of arm shoulder hand)Questionnaire by the American Academy of Orthopedic Surgeons(AAOS),which 0 indicated normal upper extremity function,and 1 to 100 indicated varying degrees of damage to the function of the upper extremties. Results:There was no neurologic complication or postoperative wound infection in this series. The followed up period ranged form 8 to 15 months(means 11 months)postopera?tively. The clinical outcomes were evaluated with DASH Questionnaire,the score before operation was 76.2±11.8,the final fol?low up score was 8.2±7.4,the final follow up score was significant higher than before operation(P<0.01). The function of the upper extremities recovered satisfactorily. Conslusion:The method of medial transposition of the radial nerve in plate fixa?tion of lower segment fracture of humerus can avoid iatrogenic radial nerve injury effectively.
