锁定钢板与交锁髓内钉内固定治疗肱骨外科颈骨折的疗效比较

发布时间：2018-05-08 15:17

本文选题：肱骨外科颈骨折 + 锁定钢板　；参考：《中国骨与关节损伤杂志》2016年03期

【摘要】：目的比较锁定钢板与交锁髓内钉内固定治疗肱骨外科颈骨折的临床疗效。方法 52例符合纳入标准的肱骨外科颈骨折分为锁定钢板组和髓内钉组,每组各26例。锁定钢板组采用切开复位锁定钢板内固定,髓内钉组采用闭合或有限切开复位交锁髓内钉内固定。比较2组手术时间、术中出血量、骨折愈合时间及术后6个月Neer肩关节功能评分。结果 52例术后获得平均7.37(6~11)个月随访。术后6个月Neer肩关节功能评分:锁定钢板组优12例,良10例,可2例,差2例,优良率84.62%;髓内钉组优12例,良11例,可2例,差1例,优良率88.46%。2组手术时间、术后6个月Neer肩关节功能评分优良率比较差异无统计学意义(P0.05)。与锁定钢板组相比,髓内钉组术中出血量减少,骨折愈合时间缩短,差异有统计学意义(P0.05)。结论锁定钢板与交锁髓内钉内固定治疗肱骨外科颈骨折术后肩关节功能无明显差异,但交锁髓内钉内固定可以减少手术创伤,促进骨折愈合。在掌握手术技巧后,建议优先选择交锁髓内钉内固定治疗肱骨外科颈骨折。
[Abstract]:Objective to compare the clinical effect of locking plate and interlocking intramedullary nail in the treatment of humeral surgical neck fracture. Methods 52 cases of humeral surgical neck fractures were divided into locking plate group and intramedullary nail group. The locking plate group was treated with open reduction and locking plate fixation, and the intramedullary nail group with closed or limited open reduction and interlocking intramedullary nail fixation. The operative time, intraoperative bleeding, fracture healing time and Neer shoulder function score 6 months after operation were compared between the two groups. Results 52 cases were followed up for an average of 7.37 ~ 6 ~ 11 months after operation. 6 months after operation, Neer shoulder function score: locking plate group was excellent in 12 cases, good in 10 cases, fair in 2 cases, poor in 2 cases, excellent and good in 12 cases, good in 11 cases, fair in 2 cases, excellent in 12 cases, good in 11 cases, fair in 2 cases in intramedullary nail group. There was no significant difference in the excellent and good rate of Neer shoulder function score 6 months after operation (P 0.05). Compared with locking plate group, intramedullary nail group had less intraoperative bleeding and shorter fracture healing time (P 0.05). Conclusion there is no significant difference between locking plate and interlocking intramedullary nail in the treatment of humeral surgical neck fracture, but interlocking intramedullary nail fixation can reduce the surgical trauma and promote fracture healing. After mastering surgical techniques, it is suggested that interlocking intramedullary nail fixation should be given priority in the treatment of humeral surgical neck fractures.
【作者单位】：深圳市宝安区福永人民医院骨科;
【分类号】：R687.3

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