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桡神经内移在肱骨干骨折固定中的应用
Hits: 2153   Download times: 346   Received:November 01, 2011    
作者Author单位UnitE-Mail
张功林 ZHANG Gong-lin 兰州军区总医院骨科研究所,甘肃 兰州 730050 Institute of Orthopaedics,Lanzhou General Hospital of Lanzhou Military Area,Lanzhou 730050,Gansu,China 668zgl@163.com 
王勇 WANG Yong 甘肃临洮县人民医院骨科  
赵来绪 ZHAO Lai-xu 甘肃武山县人民医院骨科  
杨军林 YANG Jun-lin 甘肃武山县人民医院骨科  
周建华 ZHOU Jan-hua 甘肃武山县人民医院骨科  
期刊信息:《中国骨伤》2012年25卷,第6期,第502-504页
DOI:10.3969/j.issn.1003-0034.2012.06.016


目的: 总结桡神经内移在肱骨干骨折固定中应用的结果.

方法: 2005年1月至2009年12月,对16例肱骨干骨折患者,在行前外侧钢板固定中应用桡神经内移方法治疗.其中,男12例,女4例;年龄26~49岁,平均36岁.左侧9例,右侧7例.根据AO骨折分类:6例为A3.2型,5例为A2.2型,2例为A1.2型,3例为B2.2型.应用美国骨科医师协会提出的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: 16例患者术后没有发生与手术相关的并发症,无神经损伤与伤口感染.术后随访20~46个月,平均29个月.上肢功能按DASH上肢功能量表评定,均达到了正常数值(数值为0),取得了满意的临床效果.

结论: 桡神经内移是一种安全的操作方法,不会引起医源性神经损伤,不影响对骨折的处理.在对肱骨干骨折行开放复位以及前外侧钢板固定中,该手术方法可防止桡神经受损伤.
[关键词]:肱骨骨折  桡神经  骨折固定术,内
 
Medial transposition of the radial nerve in humeral shaft fractures fixation
Abstract:

Objective: To summarize clinical outcomes of using medial transposition of the radial nerve in humeral shaft fracture fixation.

Methods: From January 2005 to December 2009,16 patients with humeral shaft fractures were treated with medial transposition of the radial nerve during open reduction and anterolateral plate fixation,included 12 males and 4 females ranging in age from 26 to 49 years,with a mean of 36 years. There were 7 fractures in the right and 9 in the left. According to AO classification,6 fractures were type A3.2,5 fractures were type A2.2,2 fractures were type A1.2 and 3 fractures were type B2.2. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS),where 0 indicates normal upper extremity function,and 1 to 100 indicate varying degrees of damage to the function of the upper extremities.

Results: There was no neurologic complication or postoperative would infection in this series. The followed-up period ranged from 20 to 46 (means 29) months postoperatively. The clinical outcomes were evaluated with DASH Questionnaire,indicating that all patients reached a normal value (value of 0). The function of the upper extremities recovered satisfactorily. There was no surgery-related complication.

Conclusion: Medial transposition of the radial nerve is safe and does not cause iatrogenic nerve injury. It protects the radial nerve during open reduction and anterolateral plate fixation of humeral shaft fractures.
KEYWORDS:Humeral fractures  Radial nerve  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:张功林,王勇,赵来绪,杨军林,周建华.桡神经内移在肱骨干骨折固定中的应用[J].中国骨伤,2012,25(6):502~504
英文格式:ZHANG Gong-lin,WANG Yong,ZHAO Lai-xu,YANG Jun-lin,ZHOU Jan-hua.Medial transposition of the radial nerve in humeral shaft fractures fixation[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(6):502~504
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