经皮微创钢板内固定术治疗肱骨中段骨折的疗效观察  

Clinical effect of minimally invasive percutaneous plate osteosynthesis for the treatment of middle humeral fracture and its influence on bone metabolism and stress response

作　　者：吴迪[1] 苏云[1] 邱士超 严佐发 高峰[1] 马严明 WU Di;SU Yun;QIU Shichao;YAN Zuofa;GAO Feng;MA Yanming(Department of orthopedics,Zhongshan hospital affiliated to Dalian university,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院骨五科,116001

出　　处：《中国老年保健医学》2019年第2期38-41,共4页Chinese Journal of Geriatric Care

摘　　要：目的探讨经皮微创钢板内固定术对肱骨中段骨折的治疗效果。方法将2016年4月至2018年2月收治的96例肱骨中段骨折患者以随机数字表法分为对照组48例,观察组48例。对照组行传统切开复位内固定术治疗,观察组行经皮微创钢板内固定术治疗。观察两组骨折愈合时间,术前、术后12周关节功能、骨代谢指标及术前、术后3d应激反应变化,术后并发症发生情况。结果术前两组关节功能无明显差异(P>0.05),术后12周观察组Constant-Murley、Mayo评分与同期对照组对比明显较高(P<0.05),观察组骨折愈合时间与对照组对比明显较短(P<0.05)。术前两组骨代谢指标无明显差异(P>0.05),术后12周观察组骨钙素(BGP)、胶原羟基末端肽(CTX)、总I型胶原氨基端延长肽(PINP)明显优于同期对照组(P<0.05)。术前两组应激反应无明显差异(P>0.05),术后均有改变,但观察组术后3d血清甲肾上腺素(NE)、皮质醇(Cor)、肾上腺素(E)水平明显较对照组低(P<0.05)。术后并发症发生率观察组为2.08%,与对照组14.58%对比,明显较低(P<0.05)。结论经皮微创钢板内固定术治疗肱骨中段骨折,可缩短骨折愈合时间,促进关节功能恢复,改善骨代谢指标,减轻应激反应,减少并发症发生,具有较高临床应用价值。Objective To evaluate the therapeutic effect of minimally invasive percutaneous plate osteosynthesis for the treatment of middle humeral fracture.Methods 96 patients with middle humeral fractures who were admitted from Apr 2016 to Feb 2018 were randomly divided into the control group(n=48)and the observation group(n=48),the control group underwent conventional open reduction and internal fixation,and the observation group underwent minimally invasive percutaneous plate osteosynthesis.Observed the fracture healing time,the changes of joints function,bone metabolism before and 12 weeks after operation and the stress response before and 3 days after operation,the postoperative complications occurred of the two groups.Results There was no significant difference in joint function between the two groups before operation(P>0.05).At 12 weeks after operation,the Constant-Murley and Mayo scores of the observation group compared with the control group at same time,significantly higher(P<0.05),the fracture healing time of the observation group compared with the control group,significantly shorter(P<0.05);There was no significant difference in bone metabolic markers between the two groups(P>0.05).At 12 weeks after operation,the osteocalcin(BGP),Collagen hydroxyterminal peptide(CTX)and total type I collagen amino terminal prolongation peptide(PINP)were in the observation group obviously better than the control group at same time(P<0.05);There was no significant difference in stress response between the two groups before operation(P>0.05),there were changes after operation,however,at 3 days after operation,the levels of serum norepinephrine(NE),cortisol(Cor)and epinephrine(E)in the observation group compared with the control group at same time,significantly lower(P<0.05);The incidence of postoperative complications was 2.08%in the observation group,compared with the control group(14.58%),significantly lower(P<0.05).Conclusion Minimally invasive percutaneous plate osteosynthesis for the treatment of middle humeral fracture can s

关 键 词：肱骨中段骨折 经皮微创钢板内固定术 关节功能 骨代谢 应激反应 

分 类 号：R687.3[医药卫生—骨科学]