Conservative Treatment of Humeral Shaft Fractures - Emphasis on the Value of Functional Brace Treatment

保守療法是治療肱骨輸骨折的優先選擇方法。管懸垂石膏或U型夾板均有很高的癒合率，能性肢架之使用更加改善了手肘關節之功能，然而使用此肢架之時機則尚未定論。從1987年1月至1989年12月共有連續的104位成年肱骨幹骨折病人在本院接受保守治療及複查至少一年以上(平均28個月)。此治療方法之原則為無法坐姿或為高位骨折者以U型夾板固定,其他之非手術適應症之骨折則以懸垂石膏固定。無法在6期達到臨床癒，則換為功能性肢架繼續固定。本研究結果為癒率88.5%及癒合期3.5±1.2個月，並且在6星期時有70.2%之骨折已達到臨床上癒合而不需換為功能性肢架。有6位原先就合併有橈骨神經麻痺者，經保守治療均得到完全復原。本研究結論為保守療法比手術方法治療肱骨幹骨折更為合理，並且不須慣例在初期就換為功能性肢架去治療所有骨折。

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並列摘要

Conservative treatment of a humeral shaft fracture has been preferred as the treatment of choice world wide. Whether using a hanging cast of a U-slab splint, a high union rate can be achieved. The utilization of a functional brace further improves the elbow function. Nevertheless, the most adequate time for functional brace administration has still not been decided. From January 1987 to December 1989, 104 consecutive adult humeral shaft fractures were treated conservatively and followed-up for at least one year (average,28 months) at the authors’ institution. The principle of conservative treatment included application of a U-slab splint for those either unable to sit upright or with a high level fracture, and a hanging cast for other fractures in which surgery was not indicated. A functional brace was applied when clinical union was not achieved after 6 weeks with casting or splinting. The results showed that the union rate was 85.8% with a union period of 3.5±1.2months. clinical union was achieved in 70.2%of fractures at 6 weeks, which did not require conversion to a functional brace. Six complete radial nerve palsy cases recovered spontaneously with conservative treatment. The authors concluded that conservativey treatment of most humeral shaft fractures shold be more reasonable than operative treatment. Furthermore,routine conversion of casting or splinting to functional brace is not favored.

並列關鍵字

conservative treatment ； humeral shaft fracture ； functional brace

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Conservative Treatment of Humeral Shaft Fractures - Emphasis on the Value of Functional Brace Treatment

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