Abstract：
BACKGROUND: Humerus shaft fractures are common in orthopaedic practice. The emphasis in treatment has shifted from prolonged immobilisation to early mobilisation and internal fixation when needed for a quicker return to normal function. Internal fixation methods include plate osteosynthesis and intramedullary nailing. This study specifically evaluated the effectiveness of flexible intramedullary nails in treating diaphyseal humeral fractures.
METHODS: Between April 2007 and January 2010, Alexandria University Hospital treated 29 patients (21 males, 8 females) with diaphyseal humeral fractures. Treatment involved closed reduction and percutaneous fixation using two flexible nails. Patients, aged 17 to 65 with a mean age of 32, were included if they did not have pathological fractures, were above 16 years old, and were medically suitable. Causes included pedestrian vehicle accidents (17 cases) and falls or sports-related activities (12 cases). Surgical intervention occurred 1 to 8 days after the injury.
RESULTS: Between April 2007 and January 2010, Alexandria University Hospital treated 29 patients (21 males, 8 females) for diaphyseal humeral fractures using closed reduction and percutaneous fixation with two flexible nails. Patients, aged 17 to 65, were monitored for an average of 18 months. Radiographic assessments showed complete union in nineteen fractures within 13 to 21 weeks. One patient experienced non-union but was successfully treated with bone grafting and plating. There were no significant intraoperative complications. Notably, four patients with preoperative radial nerve injuries recovered within 6 to 8 weeks. Evaluation using the Stewart and Hundley Scoring technique showed excellent outcomes for 60% of patients, good outcomes for 30%, fair outcomes for 5%, and poor outcomes for 5%.
CONCLUSIONS: 1.The Elastic Stable Intramedullary Nailing (ESIN) technique shows promise in the treatment of humeral shaft fractures. 2. However, the success of treatment may depend on various factors, including patient age, fracture characteristics, and the presence of complications such as open fractures and radial nerve palsy. 3. Careful consideration of these factors is necessary when selecting a treatment approach for humeral shaft fractures.
METHODS: Between April 2007 and January 2010, Alexandria University Hospital treated 29 patients (21 males, 8 females) with diaphyseal humeral fractures. Treatment involved closed reduction and percutaneous fixation using two flexible nails. Patients, aged 17 to 65 with a mean age of 32, were included if they did not have pathological fractures, were above 16 years old, and were medically suitable. Causes included pedestrian vehicle accidents (17 cases) and falls or sports-related activities (12 cases). Surgical intervention occurred 1 to 8 days after the injury.
RESULTS: Between April 2007 and January 2010, Alexandria University Hospital treated 29 patients (21 males, 8 females) for diaphyseal humeral fractures using closed reduction and percutaneous fixation with two flexible nails. Patients, aged 17 to 65, were monitored for an average of 18 months. Radiographic assessments showed complete union in nineteen fractures within 13 to 21 weeks. One patient experienced non-union but was successfully treated with bone grafting and plating. There were no significant intraoperative complications. Notably, four patients with preoperative radial nerve injuries recovered within 6 to 8 weeks. Evaluation using the Stewart and Hundley Scoring technique showed excellent outcomes for 60% of patients, good outcomes for 30%, fair outcomes for 5%, and poor outcomes for 5%.
CONCLUSIONS: 1.The Elastic Stable Intramedullary Nailing (ESIN) technique shows promise in the treatment of humeral shaft fractures. 2. However, the success of treatment may depend on various factors, including patient age, fracture characteristics, and the presence of complications such as open fractures and radial nerve palsy. 3. Careful consideration of these factors is necessary when selecting a treatment approach for humeral shaft fractures.
摘要：
背景：肱骨干骨折在骨科实践中很常见。治疗的重点已从长期固定转移到需要时的早期动员和内固定，以更快地恢复正常功能。内固定方法包括钢板接骨术和髓内钉。这项研究特别评估了柔性髓内钉治疗肱骨干骨干骨折的有效性。
方法：2007年4月至2010年1月，亚历山大大学医院收治29例患者（21例男性，8名女性）肱骨干骨折。治疗包括闭合复位和使用两个柔性钉的经皮固定。患者,年龄17至65岁，平均年龄32岁，如果他们没有病理性骨折，16岁以上，在医学上是合适的。原因包括行人车辆事故（17例）和跌倒或与运动有关的活动（12例）。损伤后1至8天进行手术干预。
结果：2007年4月至2010年1月，亚历山大大学医院收治了29名患者（21名男性，8名女性）使用闭合复位和两个柔性钉经皮固定治疗肱骨干骨折。患者,17至65岁，平均接受了18个月的监测。影像学评估显示，在13至21周内，19处骨折完全愈合。一名患者出现骨不连，但成功接受了植骨和钢板治疗。术中无明显并发症。值得注意的是,4例术前桡神经损伤患者在6～8周内恢复。使用Stewart和Hundley评分技术进行的评估显示，60％的患者具有出色的预后，30%的好结果，5%的公平结果，以及5%的不良结果。
结论：1.弹性稳定髓内钉（ESIN）技术在肱骨干骨折的治疗中显示出希望。2.然而,治疗的成功可能取决于各种因素，包括患者年龄,断裂特征，以及开放性骨折和桡神经麻痹等并发症的存在。3.选择肱骨干骨折的治疗方法时，必须仔细考虑这些因素。
方法：2007年4月至2010年1月，亚历山大大学医院收治29例患者（21例男性，8名女性）肱骨干骨折。治疗包括闭合复位和使用两个柔性钉的经皮固定。患者,年龄17至65岁，平均年龄32岁，如果他们没有病理性骨折，16岁以上，在医学上是合适的。原因包括行人车辆事故（17例）和跌倒或与运动有关的活动（12例）。损伤后1至8天进行手术干预。
结果：2007年4月至2010年1月，亚历山大大学医院收治了29名患者（21名男性，8名女性）使用闭合复位和两个柔性钉经皮固定治疗肱骨干骨折。患者,17至65岁，平均接受了18个月的监测。影像学评估显示，在13至21周内，19处骨折完全愈合。一名患者出现骨不连，但成功接受了植骨和钢板治疗。术中无明显并发症。值得注意的是,4例术前桡神经损伤患者在6～8周内恢复。使用Stewart和Hundley评分技术进行的评估显示，60％的患者具有出色的预后，30%的好结果，5%的公平结果，以及5%的不良结果。
结论：1.弹性稳定髓内钉（ESIN）技术在肱骨干骨折的治疗中显示出希望。2.然而,治疗的成功可能取决于各种因素，包括患者年龄,断裂特征，以及开放性骨折和桡神经麻痹等并发症的存在。3.选择肱骨干骨折的治疗方法时，必须仔细考虑这些因素。
