Medical insert and external fixation clamp in the
treatment of humeral shaft fractures★

Abstract

OBJECTIVE：To review the characteristics, advantages and disadvantages in treatment including internal and external fixations of humeral shaft fractures in recent years on the basis of the latest research at home and abroad.

DATA SOURCES ：The English literatures of the treatment of humeral shaft fractures were collected in the Medline database from January 1998 to December 2006 with the key words of “humeral shaft fractures, internal fixation，external fixation”. Moreover, the Chinese literatures were collected in the Wanfang database from January 1998 to December 2006 with the key words of “humeral shaft fractures, internal fixation and external fixation”.

STUDY SELECTION ：The literatures of treatment of humeral shaft fractures were selected and found the full texts after primary selection. Inclusive criteria: ①humeral shaft fractures, and ②treatment of internal fixation and external fixation. Exclusive criteria: ①proximal humeral fractures,②distal humeral fractures, ③reviews, repeated study and Meta analytical papers.

DATA EXTRACTION ： The 52 literatures of treatment of humeral shaft fractures were collected, 33 of which were brought into the article.

DATA SYNTHESIS：The methods of treatment of humeral shaft fractures were various at present. Internal and external fixations of humeral shaft fractures were mature gradually, and these methods had high healing rate. With the development of interval fixation for fracture, most of the fracture could be treated with operation. Minimally invasive plate osteosynthesis (MIPO), as a new fracture internal fixation theory, played an important role in the treatment of humeral shaft fractures.

CONCLUSION：MIPO is a great method for clinical orthopedist in middle and inferior segment of humeral shaft fractures in the future. Because of convenient operation, no movement of fixation, cheap plate (as compared with interlocking intramedullary nail), external fixation operation, which can decrease the patients' economic burden, still has high clinical application value.

摘要
目的：就近年来国内外有关肱骨干骨折的植入物及外固定架治疗的特征及优缺点作一综述。
资料来源：应用计算机检索Medline 1998－01/2006－12有关肱骨干骨折治疗方面的文献，检索词“humeral shaft fractures, internal fixation，external fixation”，并限定文献语言种类为English。同时计算机检索万方数据库1998－01/2006－12有关方面的文献，检索词为“肱骨干骨折，内固定，外固定”，并限定语言种类为中文。
资料选择：对资料进行初审，选取包括肱骨干骨折治疗的文献，开始查找全文。纳入标准：①肱骨干骨折。②内固定及外固定治疗。排除标准：①肱骨近端骨折。②肱骨远端骨折。③综述文献、重复研究、Meta分析类文章。
资料提炼：共收集到52篇关于肱骨干骨折治疗的文献，纳入33篇符合标准的文献。
资料综合：目前对于肱骨干骨折的治疗方法较多，植入物及外固定架手术已基本趋于成熟，且各种方法均有较高的骨折愈合率。随着骨折内固定技术的进步，大多数骨折都可手术治疗。经皮微创钢板内固定技术作为新的骨折内固定理念将在肱骨干的骨折治疗过程起到重要的作用。
结论：肱骨干中下段骨折的治疗采用微创的前置钢板内固定是今后临床骨科医生努力的方向。外固定支架手术由于操作较方便，无需手术拆除固定物，且价格较钢板及交锁髓内钉便宜，可从一定程度上减少患者的经济负担，仍然具有较高的临床应用价值。
关键词：肱骨干骨折，内固定，外固定

黄沛彦，安智全，曾炳芳.应用于肱骨干骨折治疗的医学植入物及外固定支架[J].中国组织工程研究与临床康复，2007，11(1):152-155
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