[肱骨干骨折的保守和手术治疗方案]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-07-25 DOI:10.1007/s00113-025-01603-9
Rike Herta Krammig, Jorge Mayor, Marcel Winkelmann, Swantje Oberthür, Stephan Sehmisch, Jan-Dierk Clausen
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引用次数: 0

摘要

背景:肱骨干骨折的发生率约为每年每10万人中有12-25例,呈现两个年龄高峰,高能量创伤后的年轻患者和低能量创伤后的老年患者。治疗:原则上,保守治疗是一种可行的选择,它要求患者的高依从性,但在适当的情况下,特别是对于椎体中部三分之一的骨折,具有良好的治愈率。与手术治疗相比,假关节的发生率略有增加。在手术治疗的情况下,钢板内固定和髓内钉均显示出良好的效果。桡神经损伤:必须区分原发性桡神经损伤和继发性桡神经损伤,前者在创伤后立即发生,通常具有良好的自发恢复率,后者是初始治疗的结果。在这种情况下,应仔细考虑手术干预的潜在需要。结论:总的来说,在适当选择的患者中,保守和手术治疗方法均可获得良好的功能预后。治疗的选择应根据患者的年龄、骨折的复杂程度、合并症和预期的患者依从性进行个体化治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Conservative and operative treatment options for humeral shaft fractures].

Background: Humeral shaft fractures occur with an incidence of approximately 12-25 per 100,000 per year and exhibit two age peaks, young patients following high-energy trauma and older patients with low-energy trauma.

Treatment: Principally, conservative treatment is a viable option, which requires high patient compliance but shows good healing rates in appropriate cases, particularly for fractures of the middle third of the shaft. Compared to surgical treatment there is a slightly increased rate of pseudarthrosis. In the case of surgical treatment, both plate osteosynthesis and intramedullary nailing show good results.

Radial nerve injury: A distinction must be made between primary radial nerve injury, which occurs immediately after trauma and generally has good spontaneous recovery rates, and secondary radial nerve injury, which is a consequence of the initiated treatment. In this case, careful consideration should be given to the potential need for a surgical intervention.

Conclusion: Overall, both conservative and surgical treatment approaches lead to good functional outcomes in appropriately selected patients. The choice of treatment should be made individually, considering the patient's age, fracture complexity, comorbidities and expected patient compliance.

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