锁定钢板与髓内钉治疗肱骨近端骨折的疗效对比

发布时间：2019-08-20 13:03

【摘要】：[目的]比较切开复位锁定钢板内固定与闭合复位髓内钉治疗肱骨近端骨折的临床疗效及安全性。[方法]对2014年2月~2016年2月收治的103例肱骨近端骨折患者病例资料进行回顾性分析,行切开复位锁定钢板内固定治疗55例(钢板组),行闭合复位髓内钉内固定治疗48例(髓内钉组)。[结果]本组患者获得6~24个月随访,平均13.2个月。两组患者手术时间、术中出血量及手术切口比较差异均有统计学意(P0.05)。两组骨折愈合时间差异无统计学意义(P0.05)。术后按照Neer肩关节功能评分标准,在骨折愈合时行肩关节功能评分,两组比较差异均有统计学意义(P0.05),而术后6个月两组比较差异无统计学意义(P0.05)。[结论]锁定钢板与髓内钉内固定治疗肱骨近端骨折术后远期肩关节功能无明显差异,但短期内肩关节功能差异明显。髓内钉内固定可以减少手术创伤,较早恢复肩关节功能,在严格掌握手术适应证的情况下,建议优先选择髓内钉内固定治疗肱骨近端骨折。
[Abstract]:[objective] to compare the clinical efficacy and safety of open reduction locking plate internal fixation and closed reduction intramedullary nail in the treatment of proximal humerus fracture. [methods] the data of 103 cases of proximal humerus fracture from February 2014 to February 2016 were analyzed retrospectively. open reduction and locking plate internal fixation were performed in 55 cases (plate group) and closed reduction and intramedullary nail fixation in 48 cases (intramedullary nail group). [results] the patients were followed up for 6 times for 24 months, with an average of 13.2 months. There were statistical differences in operation time, intraoperative blood loss and incision between the two groups (P 0.05). There was no significant difference in fracture healing time between the two groups (P 0.05). According to Neer shoulder function score, the shoulder function score was significantly different between the two groups at the time of fracture healing (P 0.05), but there was no significant difference between the two groups at 6 months after operation (P 0.05). [conclusion] there is no significant difference in long-term shoulder joint function between locking plate and intramedullary nail in the treatment of proximal humerus fracture, but there is significant difference in short-term shoulder joint function. Intramedullary nail internal fixation can reduce surgical trauma and restore shoulder function earlier. Under the condition of strictly mastering the indication of operation, it is suggested that intramedullary nail internal fixation should be given priority in the treatment of proximal humerus fracture.
【作者单位】：中国人民解放军武汉总医院;
【分类号】：R687.3

【相似文献】