摘要
目的探讨Acumed髓内钉治疗成人A3型前臂干部骨折的疗效。方法回顾性分析2016年1月至2018年12月解放军总医院采用Acumed髓内钉固定治疗的20例AO分型A3型成人前臂干部骨折患者资料。其中男18例,女2例;年龄18~56岁,平均36.5岁。桡骨干骨折6例,尺骨干折9例,前臂尺桡骨干部双骨折5例。记录患者围手术期并发症、骨折愈合时间、12个月的前臂旋转活动度、上肢功能评定表(DASH)以评价Acumed髓内钉治疗A3型前臂干部骨折的疗效。结果20例患者均获随访,时间12~18个月,平均15.8个月。所有患者均获骨性愈合,愈合时间3~4个月,平均3.3个月。3例患者出现并发症,1例为术中拇长伸肌腱部分断裂,1例为术后3个月内固定激惹至拇长伸肌腱部分断裂,1例为骨间膜线性骨化。术后12个月20例患者前臂旋前活动度80°~90°,平均89°;旋后活动度60°~90°,平均86.3°;DASH评分0~37分,平均6.5分。结论成人A3型前臂干部骨折采用Acumed髓内钉治疗骨折愈合情况良好,1年后前臂旋转活动度恢复良好;成人A3型前臂干部骨折可被列为前臂Acumed髓内钉适应证之一。
Objective To evaluate the clinical outcomes of Acumed intramedullary nailing for AO type A3 forearm diaphyseal fracture in adults.Methods A retrospective study was conducted of the 20 adult patients with AO type A3 forearm diaphyseal fracture who had been treated by Acumed intramedullary nailing from January 2016 to November 2018 at PLA General Hospital.They were 18 males and 2 females,aged from 18 to 56 years(average,36.5 years).There were 6 radius diaphyseal fractures,9 ulna diaphyseal fractures and 5 diaphyseal fractures of both forearm bones.The clinical outcomes of Acumed intramedullary nailing for AO type A3 forearm diaphyseal fractures were evaluated by recording the perioperative complications,fracture union time,forearm rotation range at 12-month follow-up,and Disability of the Arm,Shoulder and Hand Questionnaire(DASH)scores for the upper limb function.Results The 20 patients were followed up for 12 to 18 months(mean,15.8 months).Bony union was achieved in all the patients after 3 to 4 months(average,3.3 months).Partial rupture of the extensor pollicis longus tendon happened during operation in one patient and at 3 months post-operation in another due to fixation irritation,and linear ossification of interosseous membranes was observed in one patient with diaphyseal fractures of both forearm bones.12-month follow-ups showed that,in the 20 patients,forearm pronation ranged from 80°to 90°(average,89°),supination from 60°to 90°(average,86.3°)and DASH scores from 0 to 37(average,6.5).Conclusions In the treatment of AO type A3 forearm diaphyseal fracture in adults,Acumed intramedullary nailing can lead to successful fracture union and excellent rotational activity at one year after operation.Therefore,adult AO type A3 forearm diaphyseal fracture can be listed as an indication for Acumed intramedullary nailing.
作者
王浩
何红英
征华勇
吕东东
张建政
刘智
Wang Hao;He Hongying;Zheng Huayong;Lyu Dongdong;Zhang Jianzheng;Liu Zhi(Department of Microsurgery,4th Medical Center,PLA General Hospital,Beijing 100048,China;Department of Orthopedics,7th Medical Center,PLA General Hospital,Beijing 100700,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2021年第10期896-899,共4页
Chinese Journal of Orthopaedic Trauma
关键词
前臂
骨折
骨折固定术
内
骨钉
手术后并发症
Forearm
Fractures,bone
Fracture fixation,internal
Bone nails
Postoperative complications
