锁定钢板和髓内钉治疗两部分肱骨近端骨折的比较研究

发布时间：2018-03-08 09:15

本文选题：肱骨近端骨折　切入点：锁定钢板　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分别采用解剖锁定钢板及Acumed肱骨髓内钉固定的方法治疗两部分肱骨近端骨折,对其临床相关问题进行比较。方法:随访吉大一院创伤骨科自2014年7月至2016年10月期间住院手术治疗的肱骨近端两部分骨折的患者,符合入选标准的患者共68例,根据所采用的手术方式不同进行分组,采用切开复位锁定钢板内固定的40例患者分为A组。采用Acumed肱骨髓内钉固定的28例患者分为B组。对患者的随访时间不少于6个月,观察指标主要包括手术切口长度、出血量、手术时间、骨折愈合时间、术后第6个月肩关节功能评分以及术后出现的相关并发症,并对结果进行统计学分析。结果:A组(锁定钢板组)的手术时间、手术出血量、切口长度、骨折愈合时间均多于B组(髓内钉组),两组之间的比较P0.05,具有统计学意义。A组(锁定钢板组)和B组(髓内钉组)在末次随访中肩关节的活动度及肩关节功能分之间的比较具有统计学意义(P0.05)。A组(锁定钢板组)有1例患者出现肩关节活动部分受限,1例出现骨折延迟愈合,于术后第7个月愈合。B组(髓内钉组)有1例患者出现肩关节疼痛。结论:1.对于肱骨近端两部分骨折髓内钉和锁定钢板两种固定方式都能使远期关节功能得到较好的恢复,都能取得较好的临床疗效。2.对于肱骨近端两部分骨折的治疗髓内钉固定手术时间更短、手术出血量少、切口长度小、骨折愈合时间短,较锁定钢板更有优势。
[Abstract]:Objective: to treat two parts of proximal humerus fractures by anatomic locking plate and Acumed nail fixation. Methods: from July 2014 to October 2016, 68 patients with proximal humeral fractures who were treated surgically by trauma orthopedic department of the first Jida Hospital were followed up. According to the different surgical methods, 40 patients with open reduction and locking plate fixation were divided into group A and 28 patients with Acumed fixation of humeral intramedullary nail were divided into group B. the follow-up time of the patients was not less than 6 months. The main parameters included incision length, bleeding volume, operative time, fracture healing time, shoulder joint function score at the 6th month after operation, and postoperative complications, including the length of operative incision, the amount of blood loss, the time of operation and the time of fracture healing. The results were statistically analyzed. Results the operative time, bleeding volume, incision length of group A (locking plate group), The healing time of fracture was longer than that of group B (intramedullary nail group, P 0.05). There was statistical significance between group A (locking plate group) and group B (intramedullary nail group) during the last follow-up. There was a statistically significant difference between the two groups (P 0.05). Group A (locking plate group) had one patient with partially limited movement of shoulder joint and one patient with delayed fracture healing. One patient in group B (intramedullary nail group) developed shoulder joint pain at 7 months after operation. Conclusion 1. Both fixation methods of intramedullary nail and locking plate for proximal humerus fracture can make long-term joint function recover better. For the treatment of proximal humerus fracture, the fixation time of intramedullary nail is shorter, the amount of operative bleeding is less, the length of incision is small, the healing time of fracture is shorter, and it has more advantages than locking plate.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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