四动五步法与切开复位内固定治疗闭合性肱骨干骨折疗效比较  

Comparison of four action and five step method and open reduction and internal fixation for treatment of closed humerus shaft fractures

作　　者：刘西纺[1] 武全民 柯军宝 孙银娣[1] 

机构地区：[1]西安交通大学医学院附属红会医院中医骨科,陕西西安710054 [2]山东省东营市第二人民医院外二科 [3]陕西省商洛市山阳县人民医院骨科

出　　处：《中国骨与关节损伤杂志》2016年第3期267-269,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较四动五步法和切开复位内固定治疗闭合性肱骨干骨折的临床疗效，评价四动五步法非手术治疗的临床应用和推广价值。方法收集自2012-01-2014—12诊治的277例闭合性肱骨干骨折，采用非手术治疗113例（四动五步法组）。采用切开复位内固定手术治疗164例（切开复位组）。比较2组疗效优良率、骨折愈合时间、Canstant-Murley肩关节功能评分以及Mayo肘关节功能评分。结果2组均获得随访9～15个月，平均11．5个月。2组疗效优良率比较差异无统计学意义（x2=0，P=0．2）。四动五步法组骨折愈合时间较切开复位组短，差异有统计学意义（t=2．368，P=0．025）。四动五步法组Canstant—Murley肩关节功能评分为（93．60±2．83）分，切开复位组为（87．60±3．21）分；四动五步法组肩关节功能评分高于切开复位组，差异有统计学意义（f=2．763，P=0．01）。四动五步法组Mayo肘关节功能评分为（91．80±3．42）分，切开复位组为（92．50±3．17）分，2组评分差异无统计学意义（t=1．304，P=0．1）。结论四动五步法治疗闭合性肱骨干骨折具有操作简便、费用低廉、功能恢复快等优点，可以作为闭合性肱骨干骨折的首选治疗方法，值得在临床推广应用。Objective To compare the therapeutic effect of four action and five step method and internal fixation for treatment of humerus shaft fractures, and to explore the application of four action and five step method and its popularization value. Methods By the means of multieenter retrospective research, 277 patients were divided into two groups, four action and five step group （113 cases） and the operation group （164 cases） between January 2012 and December 2014. The shoulder and elbow joint function were evaluated by the Constant Murley and Mayo criteria. Other factors like the excellent and good rate and the bone healing time were also evaluated. Results The two groups were followed up for 9-15 months, and the average was 11.5 months. There was no significant difference between the two groups in the excellent and good rate（x-＇=0, P = 0.2）. The healing time of four action and five step group was shorter than that of the open reduction group, and there was significant difference （t =2.368, P =0.025）. The Canstant-Murley of shoulder joint function score of four action and five step group was 93.60＋2.83, and that of the open reduction group was 87.60±3.21. The shoulder joint function score of four action and five step group was higher than that of the open reduction group, the difference was statistically significant （t =2.763, P = 0.01）. The elbow joint function score of four action and five step group was 91.80±3.42, and the open reduction group was 92.50＋3.17. There was no significant difference between the two groups （t =1.304, P =0.1）. Conclusion Four action and five step method has significant effect in treating the closed humerus shaft fractures, with such advantages as easy manipulation, low cost, short course of treatment, as woll as the good function.

关 键 词：闭合性肱骨干骨折 四动五步法 切开复位 内固定 

分 类 号：R683.41[医药卫生—骨科学]