手法复位治疗肱骨近端骨折伴肩关节脱位的临床疗效观察

发布时间：2019-06-26 10:53

【摘要】：目的：通过观察比较肱骨近端骨折伴肩关节脱位的患者经两种不同治疗方法后骨折复位情况、肩关节功能评分、骨折愈合时间等指标,探讨过肩牵引拔伸法治疗肩关节脱位合并肱骨近端骨折的临床疗效,为肱骨近端骨折伴肩关节脱位的非手术治疗提供参考证据。方法：通过收集2014年8月至2015年8月期间收入苏州市中医院的住院及门急诊治疗的肱骨近端骨折伴肩关节脱位病例。将符合纳入标准的23例按照治疗方法分为手法复位夹板外固定组(试验组)和切开复位内固定组(对照组)。术后随访6个月,观察记录两组患者治疗后骨折复位情况、肩关节功能评分、骨折愈合时间,利用统计学分析,比较组间疗效。结果：1.治疗2周后骨折复位情况比较,试验组优良率为41.67%,对照组优良率为81.81%,两组数据经非参数秩和检验,,差别具有统计学意义(P=0.020.05)。2.治疗6个月后,试验组疼痛评分为10.16±1.34分,对照组疼痛评分为9.00+0.77分,两组数据经独立样本t检验,差别具有统计学意义(P=0.020.05)。3.治疗6个月后,试验组日常功能活动评分为12.75±1.06分,对照组为11.64±0.92分,两组数据经独立样本t检验,差别具有统计学意义(P=0.010.05)。4.治疗6个月后,试验组肌力评分为17.17±0.94分,对照组为18.82±0.75分,两组数据经独立样本t检验,差别具有统计学意义(P=0.000.05)。5.试验组骨折临床愈合时间为5.67±0.83周,对照组骨折临床愈合时间为6.59±0.94周,两组数据经独立样本t检验,差别具有统计学意义(P=0.020.05)。结论：对于肱骨近端骨折伴肩关节脱位,采用过肩拔伸牵引、夹板外固定、功能锻炼治疗,在骨折临床愈合时间及治疗6个月时日常生活改善方面优于切开复位内固定组,值得在临床上推广使用。
[Abstract]:Objective: To study the clinical effect of shoulder-shoulder traction and pull-out method in the treatment of the fracture of the proximal humerus in the patients with the proximal humeral fracture with shoulder dislocation after two different treatment methods, such as the reduction of the fracture, the function of the shoulder joint and the time of fracture healing. Reference evidence was provided for non-operative treatment of proximal humeral fractures with dislocation of the shoulder. Methods: The proximal humeral fractures with the dislocation of the shoulder joint were collected from August 2014 to August 2015 in the hospital in Suzhou. The 23 patients who met the inclusion criteria were divided into the external fixation group (trial group) and the open reduction internal fixation group (control group) according to the treatment method. The patients were followed up for 6 months, and the reduction of the fracture, the function of the shoulder joint and the healing time of the fracture were recorded and the curative effect was compared between the two groups. Results:1. The excellent and good rate was 41.67% in the test group and 81.81% in the control group, and the difference between the two groups was statistically significant (P = 0.020.05). After 6 months of treatment, the pain scores of the test group were 10.16 and 1.34 points, and the pain scores of the control group were 9.00 + 0.77 points, and the two groups of data were tested by the independent samples t, and the difference was statistically significant (P = 0.020.05). After 6 months of treatment, the daily functional activity of the test group was 12.75-1.06, the control group was 11.64-0.92, and the two groups of data were tested by independent samples t, and the difference was statistically significant (P = 0.010.05). After 6 months of treatment, the muscle strength of the test group was 17.17-0.94, the control group was 18.82-0.75, the two groups of data were tested by independent samples t, and the difference was statistically significant (P = 0.0005). The clinical healing time of the test group was 5.67 and 0.83 weeks, and the clinical healing time of the control group was 6.59 to 0.94 weeks, and the two groups of data were tested by the independent samples t, and the difference was of statistical significance (P = 0.020.05). Conclusion: For the proximal humeral fracture with the dislocation of the shoulder joint, it is better than the internal fixation group to improve the daily life in the time of clinical healing of the fracture and the improvement of the daily life at 6 months, and it is worth to be popularized and used clinically.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R244.1

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