经皮微创钢板内固定术治疗肱骨近端骨折的疗效观察

发布时间：2018-06-04 14:49

本文选题：肱骨近端骨折 + 经皮微创钢板内固定　；参考：《中国矫形外科杂志》2017年06期

【摘要】：[目的]总结应用经皮微创与切开复位钢板内固定治疗肱骨近端骨折的临床效果。[方法]对2014年1月~2014年12月手术治疗并获得随访的57例肱骨近端骨折患者进行回顾性分析,其中27例行经皮微创钢板内固定,男9例,女18例;年龄70.5(51.4~89.5)岁,按照Neer分型,二部分骨折14例,三部分骨折11例,四部分骨折2例;30例行切开复位钢板内固定,男11例,女19例,年龄69.5(52.3~86.8)岁,按照Neer分型,二部分骨折13例,三部分骨折14例,四部分骨折3例。从手术相关指标、患侧Neer肩关节功能评分及术后并发症情况3个方面对两种治疗方法进行比较分析。[结果]:57例患者获得随访,时间13~24个月,平均17.8个月。术后出现感染、腋神经损伤、肱骨头坏死各1例,内固定失效3例。经皮微创组手术切口长度、术中出血量、住院天数、骨折愈合时间均优于切口组,两组间差异有统计学意义(P0.05),而手术时间比较两组差异无统计学意义(P0.05)。术后并发症的发生率两组比较差异无统计学意义(P0.05),术后12个月的肩关节功能Neer评分两组比较差异无统计学意义(P0.05)。[结论]:经皮微创钢板内固定治疗肱骨近端骨折具有创伤小、骨折愈合快等特点。
[Abstract]:Objective: to summarize the clinical effect of percutaneous minimally invasive and open reduction plate internal fixation for proximal humerus fracture. [methods] 57 patients with proximal humerus fractures treated by surgical treatment from January 2014 to December 2014 were retrospectively analyzed. Among them, 27 cases were treated with percutaneous minimally invasive plate fixation, 9 males and 18 females, aged 70.5 years, 51.4% and 89.5 years old, according to Neer classification. There were 14 cases of two-part fracture, 11 cases of three-part fracture, 30 cases of four-part fracture, male 11 cases, female 19 cases, age 69.5% 52.3% (86.8) years old. According to Neer classification, there were 13 cases of two-part fracture and 14 cases of three-part fracture. There were 3 cases of four-part fracture. The two treatment methods were compared and analyzed from three aspects: operative related indexes, shoulder function score of affected side Neer and postoperative complications. [results] 57 cases were followed up for 13 ~ 24 months (mean 17.8 months). Postoperative infection, axillary nerve injury, humeral head necrosis in 1 case, failure of internal fixation in 3 cases. The length of incision, the amount of intraoperative bleeding, the days of hospitalization and the time of fracture healing in the percutaneous minimally invasive group were better than those in the incision group. The difference between the two groups was statistically significant (P 0.05), but there was no significant difference in the operation time between the two groups. There was no significant difference in the incidence of postoperative complications between the two groups (P 0.05), and there was no significant difference in the Neer score of shoulder joint function between the two groups 12 months after operation (P 0.05). Conclusion: the treatment of proximal humerus fracture by percutaneous minimally invasive plate fixation has the characteristics of less trauma and faster healing.
【作者单位】：暨南大学医学院附属广州红十字会医院骨科;
【分类号】：R687.32

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