Fixation with intramedullary nail and plate in the treatment of adult humeral shaft fracture:comparison of radial nerve injury and non-union rate
10.3969/j.issn.2095-4344.2015.13.022
- VernacularTitle:髓内钉和钢板置入修复成人肱骨干骨折：桡神经损伤及骨不愈合发生率比较
- Author:
Tao FENG
- Publication Type:Journal Article
- Keywords:
Humerus;
Fractures,Bone;
Bone Nails;
Internal Fixators;
Fracture Healing
- From:
Chinese Journal of Tissue Engineering Research
2015;(13):2086-2090
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Internal fixation is the main treatment of humeral shaft fractures, especial y for cases accompanied several injuries. According to the fracture reduction method and fixation methods, the commonly used repair methods include intramedul ary nail and minimal y invasive plate. How to choose a safe and effective method of internal fixation is a hot issue in the repair of humeral shaft fractures. OBJECTIVE:To explore the clinical effect of different fixations of intramedul ary nail and plate in the treatment of adult humeral shaft fracture. METHODS:A total of 252 patients with humeral shaft fracture recruited from Heze Municipal Hospital from May 2010 to May 2013 were randomly divided into two groups, with 126 cases in each group. Patients in the two groups were treated with intramedul ary nail fixation and plate fixation, respectively. The average operation time, intraoperative blood loss, hospital stays, and healing time of fracture in the two groups were recorded. Al patients were fol owed up for 1 year postoperatively, the incidence of radial nerve injury, infection and non-union was compared. The recovery of shoulder joint and elbow joint of patients was assessed with Neer method and Mayo method, respectively. RESULTS AND CONCLUSION:After treatment, the rate of primary success of internal fixation showed no significant differences between the two groups (χ2=0.399 7, P>0.05). The average operation time, intraoperative blood loss, the healing time of fracture and hospital stays in the intramedul ary nail group were significantly shorter than that in the plate group B, the difference of the results were extremely significant in two groups (t=15.442 5, 21.713 4, 8.217 6, 1.214 8, P<0.01). After 1-year fol ow-up, the incidence of radial nerve injury showed extremely significant differences between the two groups (χ2=8.262 3, P<0.01);the incidence of nonunion in the intramedul ary nail group was significantly lower than that in the plate group, with extremely significant differences (χ2=3.947 2, P<0.05). The overal incidence of complications in intramedul ary nail group was significantly lower than that in the plate group, with extremely significant difference (χ2=11.977 9, P<0.01). Besides, the Neer scores of shoulder joint and the Mayo scores of elbow joint between the two groups had no statistical y significant difference (χ2=0.235 4, 0.273 0, P>0.05). Both intramedul ary nail and plate fixations show good clinical effect in treatment of adult humeral shaft fracture, and each technique has their advantages and disadvantages, we should choose the proper technique according to the patient’s condition.
