肱骨干骨折手术与非手术治疗的比较

发布时间：2018-08-11 11:11

【摘要】：目的:比较肱骨干骨折手术与非手术治疗方法的临床疗效,以期指导临床选择。方法:连续入选2005年3月至2012年10月间有完整随访资料的患者252例,根据治疗方法的不同将患者分为保守治疗组和手术内固定组,其中保守治疗组76例使用石膏或小夹板固定骨折,手术内固定组176例使用切开复位钢板或髓内针固定骨折。对两组间并发症发生率、骨折愈合时间、骨折愈合率、Constant-Murley肩关节功能评分和Mayo肘关节功能评分等参数进行比较。结果:平均随访(31.24±20.06)个月。两组数据在年龄、开放骨折数量、骨折部位和AO(Arbeitsgemeinschaft für Osteosynthesefragen)分类方面差异没有统计学意义。骨折愈合率:保守治疗组96.1%(73/76),手术内固定组97.7%(172/176),P=0.46;骨折愈合时间:保守治疗组(10.24±2.93)周,手术内固定组(10.69±2.51)周,P=0.22;并发症发生率:保守治疗组5.3%(4/76例),手术内固定组15.3%(27/176例),P=0.025;其中骨折不愈合率:保守治疗组3.95%(3/76),手术内固定组2.3%(4/176),P=0.43;桡神经损伤:保守治疗组0%(0/76),手术内固定组5.7%(10/176),P=0.035;骨劈裂:保守治疗组0%(0/76),手术内固定组1.7%(3/176),P=0.556;肘僵硬:保守治疗组1.3%(1/76),手术内固定组0.6%(1/176),P=1.000;肩痛:保守治疗组0%(0/76),手术内固定组5.1%(9/176),P=0.061。Constant-Murley肩关节功能评分:保守治疗组(97.37±4.94)分,手术内固定组(96.34±6.88)分,P=0.24;Mayo肘关节功能评分:保守治疗组(99.80±1.72)分,手术内固定组(99.49±2.73)分,P=0.36。结论:肱骨干骨折保守治疗与手术治疗的疗效相当,但并发症少。
[Abstract]:Objective: to compare the clinical effect of operative and non-operative treatment of humeral shaft fracture. Methods: 252 consecutive patients with complete follow-up data from March 2005 to October 2012 were selected and divided into conservative treatment group and operative internal fixation group according to different treatment methods. 76 cases in conservative treatment group were fixed with plaster or splint, 176 cases in operation group were fixed with open reduction plate or intramedullary needle. The incidence of complications, fracture healing time, fracture healing rate, Constant-Murley shoulder function score and Mayo elbow function score were compared between the two groups. Results: the average follow-up was (31.24 卤20.06) months. There were no significant differences in age, number of open fractures, fracture site and AO (Arbeitsgemeinschaft f 眉 r Osteosynthesefragen) classification between the two groups. Fracture healing rate was 96.1% (73 / 76) in conservative treatment group, 97.7% (172 / 176) in internal fixation group, 0.46% in internal fixation group, and (10.24 卤2.93) weeks in conservative treatment group. The incidence of complications was 5.3% (4 / 76) in the conservative treatment group and 15.3% (27 / 176) in the internal fixation group, among which the fracture nonunion rate was 3.95% (3 / 76) in the conservative treatment group, 2.3% (4 / 176) in the internal fixation group, 0% (0 / 76) in the conservative treatment group, and 0% (0 / 76) in the internal fixation group. Osteoschisis: 0% (0 / 76) in conservative treatment group, 1.7% (3 / 176) in internal fixation group, 0.556% in internal fixation group; elbow stiffness: 1.3% (1 / 76) in conservative treatment group, 0.6% (1 / 176) P 1.000 in internal fixation group, 0% (0 / 76) in conservative treatment group, 5.1% (9 / 176) in internal fixation group, (97.37 卤4.94) points in conservative treatment group, (97.37 卤4.94) points in conservative treatment group. The score of elbow function in the internal fixation group (96.34 卤6.88) was (99.80 卤1.72) in conservative treatment group and (99.49 卤2.73) in operative internal fixation group (P = 0.36). Conclusion: conservative treatment of humeral shaft fracture is equivalent to surgical treatment, but there are few complications.
【作者单位】：北京积水潭医院创伤骨科;河北省人民医院骨科;
【分类号】：R687.3

【相似文献】