交锁髓内钉与锁定钢板治疗肱骨中上段骨折的疗效对比研究  

Comparative Research on the Clinical Efficacy of Interlocking Intramedullary Nail and Locking Plate in the Treatment of Proximal Humeral Fracture

作　　者：许大峰[1,2] 顾龙殿[1,2] 顾利华[1,2] 白祥[1,2] 敖荣广[1,2] 

机构地区：[1]上海市浦东医院 [2]复旦大学附属浦东医院骨科,上海201300

出　　处：《现代生物医学进展》2013年第13期2547-2549,2589,共4页Progress in Modern Biomedicine

摘　　要：目的:分析交锁髓内钉与锁定钢板治疗肱骨中上段骨折的疗效。方法:选择2010年1月～2011年12月在我院就诊的肱骨中上段骨折患者90例,按照随机配对将其分为两组:交锁髓内钉组和锁定钢板组,每组各45例。观察和比较两组患者的手术时间、术中出血量、骨折愈合时间、住院时间、Constant肩关节评分、Mayo肘关节评分和并发症发生率。结果:两组患者均获随访,平均13(6～24)个月。锁定钢板组的治疗有效率为88.89%,而交锁髓内钉组的治疗有效率为93.33%,两组差异无统计学意义(P>0.05)。但交锁髓内钉组患者的手术时间、术中出血量、骨折愈合时间、住院时间、Constant肩关节评分均较锁定钢板组明显缩短、减少或降低(P<0.05或<0.01),而两组的Mayo肘关节评分差异无统计学意义(P>0.05)。锁定钢板组的并发症发生率为24.44%,明显高于交锁髓内钉组的6.67%(P<0.05)。结论:交锁髓内钉与锁定钢板内固定治疗肱骨中上段骨折的疗效接近,但交锁髓内钉组的具有创伤小,恢复快,并发症少的优点,而锁定钢板组对肩关节功能影响较小。Objective： To compare the clinical efficacy and safety of interlocking intramedullary nail with locking plate in the treatment of proximal humeral fracture.Methods： 90 patients with proximal humeral fracture hospitalized from January 2010 to December 2011were selected and randomly divided into 2 groups according to the operation method： interlocking intramedullary nail group and locking plate group,45 cases in each group.The operation time,intraoperative blood loss,healing time of fracture,hospital stays,constant shoulder score,Mayo elbow score and incidence rate of complications were observed and compared between the two groups.Results： All patients were followed up from 6 to 24 months,with an average of 13 months.The total effective rates in elocking plate group and interlocking intramedullary nail group were respectively 88.89% and 93.33%,no significant difference was found between the two groups（P0.05）.The operation time,intraoperative blood loss,healing time of fracture,hospital stays,constant shoulder score in interlocking intramedullary nail group were all significantly lower or shorter than those in locking plate group（P0.05 or 0.01）,while no significant difference of the Mayo elbow score was observed between two groups（P0.05）.The incidence rate of complications was 24.44% in locking plate group,which was significantly higher than that in interlocking intramedullary nail group（6.67%,P0.05）.Conclusion： The efficacy of interlocking intramedullary nailing on proximal humeral fracture was close to locking plate,and the interlocking intramedullary nail had the merits of smaller wound,earlier recovery and fewer complications,while the lock plate had fewer impact on the shoulder function.

关 键 词：肱骨骨折 交锁髓内钉 锁定钢板 临床疗效 安全性 

分 类 号：R683.41[医药卫生—骨科学]