有限切开复位内固定结合外固定架治疗肱骨干粉碎性骨折的疗效分析  

Efficacy of Limited Open Reduction Internal Fixation Combined with External Fixator in the Treatment of Humeral Shaft Comminuted Fracture

作　　者：李盛华[1] 王久夏[1] 申建军[1] 

机构地区：[1]甘肃省中医院,兰州730050

出　　处：《中国中医骨伤科杂志》2016年第7期12-15,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：甘肃陇中正骨学术流派传承工作室建设项目

摘　　要：目的：探讨有限切开复位内固定结合外固定架治疗肱骨干粉碎性骨折的微创手术方法和临床疗效。方法：选取甘肃省中医院2011年10月至2014年9月住院治疗的肱骨干粉碎性骨折患者,采用有限切开复位内固定结合外固定架治疗的60例患者作为观察组,选择同期53例切开复位加压钢板内固定治疗的患者作为对照组。术后随访6-26个月,分析两组患者相关临床资料,评价两组患者Constant肩关节功能、Mayo肘关节功能、骨折愈合情况、住院时间及并发症发生率。结果：观察组和对照组Constant肩关节功能评分优良率分别为91.6%和86.7%;观察组和对照组Mayo肘关节功能评分优良率分别为95%和90.6%,差异无统计学意义（P〉0.05）。术后定期复查X线片,观察组骨折全部愈合,骨折愈合时间11-37周（19.4±4.8）;对照组骨折愈合率98.1%,除对照组1例骨折不愈合外,其余患者骨折愈合时间11-38周（22.0±5.6）,差异无统计学意义（P〉0.05）。观察组并发症发生率为5.0%（3例）,对照组为3.8%（2例）,差异有统计学意义（P〉0.05）。观察组术后住院时间明显少于对照组,差异有统计学意义（P〈0.05）。结论：有限切开复位内固定结合外固定架治疗肱骨干粉碎性骨折能够提供较好的稳定性和功能恢复,并且较传统内固定损伤小,有效减少住院时间,避免二次手术,值得临床推广。Objective：To evaluate curative effect of the limited open reduction internal fixation combined with external fix- ator in the treatrnent of humeral shaft comminuted fracture. Methods.-All cases were hospitalized patients with humeral comminuted fracture in Gansu province hospital of traditional Chinese medicine from Oct 2011 to Sep 2014. Sixty patients were treated with limited open reduction internal fixation combined with external fixation （observation group） ,as other 53 patients were treated with open reduction with compression steel plate internal fixation （control group）. They were all followed up for 6-24 months postoperatively. The relevant clinical data,Constant shoulder function score,Mayo elbow function score, fracture healing, length of hospital stay, and complications were analyzed. Results; The Constant shoulder joint function score was 91.6% and 86.7% in observation group and control group respectively. The Mayo elbow joint function score was 95% and 90. 6% in observation group and control group respectively, there was no statistically significant difference （P〉0.05）. All fractures healed in observation group postoperative according to X-ray, the fracture healing time were 11-37 weeks（19.4±4.8）. The fracture healing rate was 98.1% in control group,the fracture healing time were 11 38 weeks（22.0± 5.6）. There was no statistically significant difference （P〉0.05）. The complication rate was 5 % （3 cases） and 3.8 % （2 cases） in the observation group and control group respectively,the difference was statistically significant （P〉0.05）. The hospital stay in observation group was obviously less than control group （P〈0.05）. Conclusion： Limited open reduction internal fixation combined with external fixator in the treatment of humeral comminuted fractures can provide better stability and functional recovery, and less damage than traditional internal fixation, effectively reduce hospitalization time, avoid secondary surgery, it is worth for clinical promo

关 键 词：肱骨干粉碎性骨折 有限内固定 外固定 

分 类 号：R683.41[医药卫生—骨科学]