增强固定技术用于冰雪运动所致肱骨近端骨质疏松骨折治疗的研究  

Study on the application of enhanced fixation technique in the treatment of proximal humeral osteoporosis fracture caused by ice and snow exercise

作　　者：潘东续 刘玉章[1] 钟蔼云 杨靖 李耀华[1] 唐晓龙[1] 段永刚[1] 丁英奇[1] PAN Dongxu;LIU Yuzhang;ZHONG Aiyun;YANG Jing;LI Yaohua;TANG Xiaolong;DUAN Yonggang;DING Yingqi(The Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei,China)

机构地区：[1]河北北方学院附属第二医院

出　　处：《现代中西医结合杂志》2019年第22期2408-2411,2428,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省重点研发计划自筹项目(182777164)

摘　　要：目的探讨增强固定技术在冰雪运动所致肱骨近端骨质疏松骨折中的应用效果。方法搜集因冰雪运动或冬季地面结冰滑倒导致肱骨近端骨质疏松骨折的老年患者65例,依据固定方式不同分为A(n=26)、B(n=21)、C(n=18)3组,3组均采用肱骨近端锁定内固定进行治疗,A组采用磷酸钙骨水泥增强固定,B组采用同种异体骨条增强固定,C组单纯实施锁定钢板螺钉固定。比较3组骨折愈合时间、术后颈干角、肱骨头高度丢失及手术前后肩关节功能和肩关节各方向活动度,记录3组并发症发生情况。结果与C组比较,A、B2组骨折愈合时间更短(P均<0.05),术后颈干角更大(P均<0.05),肱骨头高度丢失更小(P均<0.05);但A、B2组间比较无明显差异(P均>0.05)。与术前比较,术后2个月3组患者疼痛、功能、运动限制及解剖复位评分均明显升高(P均<0.05),且A、B2组均明显高于C组(P均<0.05);但A、B2组间比较无明显差异(P均>0.05)。与术前比较,术后1周3组患者肩关节前屈、后伸、内收、外展时活动度均明显增加(P均<0.05),且A、B2组均明显大于C组(P均<0.05)。A、B2组并发症发生率均明显低于C组(P<0.05),A、B2组间比较无明显差异(P>0.05)。结论增强固定技术治疗冰雪运动所致肱骨近端骨质疏松骨折,可明显促进骨折愈合,改善肩关节功能及活动度,并发症少,有利于术后患者康复。Objective It is to investigate the applicating effect of enhanced fixation technique on the proximal humeral osteoporotic fracture caused by ice and snow exercise.Methods A total of 65 elderly patients with osteoporosis fractures of the proximal tibia caused by snow and ice or winter ground icing slips were collected and divided into group A(n=26),group B(n=21)and group C(n=18)according to their fixation methods.All the three groups were treated with proximal humeral locking and internal fixation,group A was fixed with calcium phosphate cement,and group B was fixed with allogeneic bone strip,Group C was simply fixed with a locking plate screw.The fracture healing time,postoperative neck shaft angle,humeral head height loss and shoulder joint function and shoulder joint motion before and after treatment were compared,and the complications of the three groups were recorded.Results Compared with group C,the healing time of fractures in group A and group B was significantly shortened,the neck shaft angle was significantly increased,and the height loss of humeral head was significantly reduced(P<0.05),however,there was no significant difference between group A and group B(P>0.05).Compared with that before operation,the scores of pain,function,exercise limitation and anatomical reduction of the three groups were significantly increased after operation,and the scores in group A and group B were significantly higher than those in group C(P<0.05);but there was no significant difference between group A and group B(P>0.05).Compared with that before operation,the mobility of shoulder flexion,extension,adduction and abduction were significantly increased in the three groups in 1 week after operation,and the mobility in group A and group B were significantly better than group C(P<0.05).The incidence of complications in group A and group B was significantly lower than that in group C(P<0.05),but there was no significant difference between group A and group B(P>0.05).Conclusion Enhanced fixation technique for the treatment of os

关 键 词：增强固定技术 锁定钢板内固定系统 肱骨近端骨质疏松骨折 

分 类 号：R683.41[医药卫生—骨科学]