微创螺钉内固定治疗肱骨投弹骨折临床分析
Clinical Analysis of Minimally Invasive Internal Fixation Screw in Treatment of Throwing Fracture of the Humeral Shaft

目的：分析微创螺钉内固定治疗肱骨投弹骨折的临床疗效。方法：回顾性分析2010年2月至2020年12月收治的63例肱骨投弹骨折的临床资料，X线片上测量骨折长度(L)，骨折斜面角度(α)，骨折中点直径(D)，并计算L/D比值，记录手术时间、出血量、术后住院时间、随访记录骨折愈合时间、并发症及肩肘关节功能恢复情况。结果：63例投弹骨折均为肱骨中下段螺旋骨折，骨折长度(L) 38~112 mm，骨折斜面角度(α) 33？~43？，骨折中点直径(D) 19~28 mm，L/D比值为2.5~4.1。平均手术时间50分钟，平均出血量90 ml。住院时间5~12天，平均8天。术后随访6~18个月，平均13.1个月。63例均在9~20周内临床愈合，平均13.4周。按Cassebaum评分，本组肩、肘关节功能优60例，良3例，优良率100%。结论：肱骨投弹骨折是不稳定螺旋骨折，采用微创螺钉内固定方法治疗肱骨投弹骨折，操作简单，手术安全，损伤小，固定合理，骨折愈合时间短，疗效满意。
Objective: To analyze the clinical effects of Minimally Invasive Screw for throwing fracture of humeral shaft. Methods: Between February 2010 and December 2020, 63 patients with humeral shaft fracture were treated, and clinical data were retrospectively analyzed. Sixty-three cases were studied by measuring fracture length, fracture angles and diameter of fracture midpoint in X-ray films, then calculating ratio of L to D. Operation time, bleeding volume, length of stay and time of fracture union, incidence rate of complications and shoulder and elbow function were recorded. Results: Sixty-three cases were spiral fractures. All cases were located in middistal portion of the humerus. All cases had fracture lengths between 38 mm to 112 mm and fracture angles between 33？ to 43？. Diameter of fracture midpoint ranged from 19 mm to 28 mm. Ratio of L to D was 2.5~4.1. The mean operation time was 50 minutes and the mean blood loss was 90 ml. The hospital stay ranged from 5 to 12 days with an average of 8 days. The post-operation follow up ranged from 6 to 18 months with an average of 13.1 months. The bone healing was obtained after 9~20 weeks and the average clinical healing period was 13.4 weeks. According to Cassebaum’s critcria function recovery of shoulder and elbow of all cases were excellent in 60 cases, good in 3 cases, the excellent and good rate was 100%. Conclusion: Throwing Fracture of the humeral shaft is an unstable spiral fracture. Minimally Invasive Screw internal fixation has advantages of simplicity, safety, less injury, reasonable internal fixation, short fracture union time and good results can be obtained in treatment of throwing fracture of humeral shaft.