闭合复位内外固定结合中医康复治疗肱骨近端骨折的临床研究  

Clinical study on closed reduction and internal & external fixation combined with TCM rehabilitation in the treatment of proximal humeral fractures

作　　者：李卫国[1] 孙献武[1] 谭训香[1] 刘双双[1] 

机构地区：[1]山东省文登整骨医院,山东文登264400

出　　处：《中医正骨》2016年第5期1-4,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的：观察闭合复位内外固定结合中医康复治疗肱骨近端骨折的临床疗效。方法：将符合要求的87例肱骨近端骨折患者随机分为2组,行闭合复位内外固定术,术后分别采用中医康复和常规康复治疗。随访观察2组患者的骨折愈合时间及肩关节功能恢复时间,并于治疗20周后采用Constant-Murley肩关节评分标准评定疗效。结果：所有患者均获随访,随访时间8~18个月,中位数14个月。中医康复组的骨折愈合时间及肩关节功能恢复时间均短于常规康复组[（11.94±1.20）周,（13.02±1.64）周,t=2.790,P=0.007;（15.80±2.11）周,（17.47±2.14）周,t=3.664,P=0.000]。Constant-Murley肩关节评分中,中医康复组的疼痛评分低于常规康复组[（4.60±1.12）分,（5.40±1.14）分,t=3.239,P=0.002],日常活动评分及关节活动范围评分高于常规康复组[（15.70±2.24）分,（14.64±1.90）分,t=2.362,P=0.020;（30.76±3.65）分,（28.47±4.23）分,t=2.714,P=0.008],而2组肌力评分比较,差异无统计学意义（t=1.628,P=0.107）。结论：对肱骨近端骨折实施闭合复位内外固定后采用中医康复治疗,骨折愈合快,肩关节功能恢复好,值得临床推广应用。Objective： To observe the curative effect of closed reduction and internal external fixation combined with TCM rehabilitation in the treatment of proximal humeral fractures. Methods： Eighty-seven patients with proximal humeral fractures enrolled in the study were randomly divided into 2 groups,and were treated with closed reduction and internal external fixation. After the surgery,the patients were treated with TCM rehabilitation（ TCM rehabilitation group） and conventional rehabilitation（ conventional rehabilitation group） respectively. The patients were followed up,and the fracture healing time and the shoulder function recovery time were observed and compared between the 2 groups. After 20- week treatment,the curative effect was evaluated by using Constant- Murley shoulder joint scoring criterion.Results： The patients in the 2 groups were followed up for 8- 18 months with a median of 14 months. The fracture healing time and the shoulder function recovery time were shorter in TCM rehabilitation group compared to conventional rehabilitation group（ 11. 94 ＋ /- 1. 20 vs13. 02 ＋ /- 1. 64 weeks,t = 2. 790,P = 0. 007; 15. 80 ＋ /- 2. 11 vs 17. 47 ＋ /- 2. 14 weeks,t = 3. 664,P = 0. 000）. The Constant- Murley shoulder pain scores were lower in TCM rehabilitation group compared to conventional rehabilitation group（ 4. 60 ＋ /- 1. 12 vs 5. 40 ＋ /-1. 14 points,t = 3. 239,P = 0. 002）. The Constant- Murley shoulder daily activity scores and joint motion range scores were higher in TCM rehabilitation group compared to conventional rehabilitation group（ 15. 70 ＋ /- 2. 24 vs 14. 64 ＋ /- 1. 90 points,t = 2. 362,P = 0. 020;30. 76 ＋ /- 3. 65 vs 28. 47 ＋ /- 4. 23 points,t = 2. 714,P = 0. 008）. There was no statistical difference in muscle strength scores between the2 groups（ t = 1. 628,P = 0. 107）. Conclusion： Short fracture healing time and good shoulder function can be obtained by using TCM rehabilitation in patients with proximal humeral fractures after closed reduction and inter

关 键 词：肱骨骨折 肩骨折 骨折固定术 中医康复 临床试验 

分 类 号：R274.9[医药卫生—中西医结合]