杉树皮夹板固定治疗肱骨近端骨质疏松性骨折的临床研究

发布时间：2018-07-24 12:37

【摘要】：目的：评估非手术(手法复位杉树皮夹板外固定配合中药三期用药及功能锻炼)治疗肱骨近端骨质疏松性骨折的临床疗效。方法：通过总结分析自2008年7月-2013年12月间浙江省拱墅区人民医院外科收治的临床诊断为肱骨近端骨质疏松性骨折符合纳入标准且均获完整随访的60例病例。本研究所纳入的病例中男性22例,女性38例,年龄最大94岁,最小63岁,平均年龄78岁。根据其治疗方法的不同,将其分为两组：A组30例手法整复、杉树皮夹板外固定配合中药三期用药；B组30例手法整复、石膏外固定配合中药三期用药：观察治疗后第4周,第8周,第24周的肩关节功能恢复情况(采用Neer百分制评分对肩关节功能评分)。并采用Spss satistics 19.0软件进行分析。结果：两种治疗方法患者的基线资料, 经统计学检验, 差异无显著性(P0.05)。两种治疗方法在第4周时,解剖评分、疼痛评分、活动范围及功能评分均差异无显著性(P0.05) ；第8周时,解剖评分、疼痛评分差异无显著性(P0.05),活动范围及功能评分差异有显著性(P0.05) ；第24周时,解剖评分、疼痛评分及活动范围差异无显著性(P0.05),功能评分差异有显著性(P0.05)A组优良率90.0%优10例、良17例、中2例、差1例；B组优良率86.7%优9例、良17例、中2例、差2例。结论：杉树皮夹板固定和石膏固定肱骨近端骨质疏松性骨折的疗效对比,在解剖评分、疼痛评分上无明显差别,在功能评分及活动范围上杉树皮夹板固定优于石膏固定。对于肱骨近端骨质疏松性骨折总体疗效杉树皮夹板固定优于石膏固定。杉树皮夹板外固定符合现代骨科倡导的生物力学观点,能有效防止应力遮挡,并且据有操作简单、创伤小、并发症少、费用低、减轻患者经济负担的优点,是一种可靠的治疗方法,在临床上有一定推广价值。
[Abstract]:Objective: to evaluate the clinical effect of non-operative treatment of osteoporotic fracture of proximal humerus. Methods: from July 2008 to December 2013, 60 cases of osteoporotic fracture of proximal humerus which were diagnosed as osteoporotic fracture of proximal humerus were reviewed and analyzed. There were 22 males and 38 females, aged 94 and 63 years, with an average age of 78 years. According to the different treatment methods, the patients were divided into two groups: 30 cases in group A, 30 cases in group B, 30 cases in group B, and 3 cases in group B: observe the 4th week after treatment. The recovery of shoulder function was observed at the 8th week and the 24th week (using the Neer percentile score). The software Spss satistics 19.0 was used to analyze. Results: there was no significant difference in baseline data between the two treatments (P0.05). There was no significant difference in anatomic score, pain score, range of activity and functional score between the two treatments at the 4th week (P0.05), while at the 8th week, the anatomic score was not significantly different from that of the control group. There was no significant difference in pain score (P0.05), but there was significant difference in activity range and function score (P0.05); at the 24th week, there was no significant difference in anatomical score, pain score and range of activity (P0.05), and there was significant difference in functional score (P0.05). The excellent and good rate was 86.7% in group B, good in 17 cases, fair in 2 cases and poor in 2 cases. Conclusion: there is no significant difference in anatomical score and pain score between fir splint fixation and plaster fixation for proximal humerus osteoporotic fracture, but in function score and activity range, fir bark splint fixation is superior to plaster fixation. General effect on osteoporotic fracture of proximal humerus the fixation of Chinese fir skin splint is superior to plaster fixation. The external fixation of Chinese fir bark splint accords with the biomechanical viewpoint advocated by modern orthopedic department, and it can effectively prevent stress occlusion, and has the advantages of simple operation, less trauma, less complications, low cost and lightening the economic burden of patients. It is a kind of reliable treatment method, and has certain popularizing value in clinic.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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