双头加压螺钉及微型锁定接骨板在桡骨小头骨折内固定中的应用  

Application of double-head compression screw and micro-locking plate in internal fixation of humeral head fracture

作　　者：蔡英富 崔顺平 秦立亭 CAI Ying-fu;CUI Shun-ping;QIN Li-ting(Orthopedics Hospital,the First Hospital of Hanbin District of Ankang City,Ankang 725000,Shaanxi,CHINA;Department of Orthopedics,the Chinese Medicine Hospital of Yulin City,Yulin 719000,Shaanxi,CHINA)

机构地区：[1]安康市汉滨区第一医院骨科医院,陕西安康725000 [2]榆林市中医医院骨科,陕西榆林719000

出　　处：《海南医学》2019年第19期2507-2510,共4页Hainan Medical Journal

摘　　要：目的研究双头加压螺钉及微型锁定接骨板在桡骨小头骨折内固定中的应用效果。方法选取2014年10月至2018年9月在安康市汉滨区第一医院骨科医院进行诊治的48例根据Mason分型判定为Ⅲ型的桡骨小头骨折患者,按照随机数表法将其分为观察组和对照组,每组24例。观察组患者采用双头加压螺钉进行内固定,对照组患者采用微型锁定接骨板进行内固定。于术后6个月,比较两组患者的改良式Broberg and Morrey评分、桡肘关节活动度及并发症发生情况,同时进行影像学检查,观察骨骼愈合情况。结果48例患者完成研究,从愈合情况上看所有患者的骨折线均已愈合,无法从阅片中观测到明显的骨折线;观察组患者的手术时间和住院时间分别为(76.80±10.98)min、(14.28±0.85)d,分别与对照组的(78.16±9.87)min、(14.61±1.16)d比较差异均无统计学意义(P>0.05);观察组患者的Broberg and Morrey评分为(88.79±4.27)分,明显高于对照组的(81.60±5.75)分,差异具有统计学意义(P<0.05);观察组患者的肘关节屈曲角度、前臂旋前角度、前臂旋后角度分别为(131.26±0.87)°、(83.21±2.90)°和(84.92±2.33)°,均明显高于对照组的(118.63±5.27)°、(75.12±3.81)°和(74.31±2.67)°,差异均有显著统计学意义(P<0.01);观察组患者的并发症发生率为8.33%,明显低于对照组的33.33%,差异有统计学意义(P<0.05)。结论双头加压螺钉技术在桡骨小头骨折的内固定治疗中有着很好的应用价值,其固定效果良好,能有效改善患者桡关节基本功能和稳定性的恢复,且并发症发生较少,是目前较为安全可靠的内固定手术方案。Objective To explore and study the application value and effect of double-head compression screw and micro-locking plate in the internal fixation of humeral head fracture.Methods Forty-eight patients with humeral head fractures,who diagnosed as typeⅢaccording to Mason classification in Department of Orthopaedics,First Hospital of Hanbin District of Ankang City from October 2014 to September 2018,were selected and divided into the observation group and control group according to random number table method,with 24 cases in each group.The patients in the observation group were fixed with double-head compression screw,and patients in the control group were fixed with micro-locking plate.The modified Broberg and Morrey scores,elbow joint mobility,and complications were compared between the two groups at 6 months postoperatively.At the same time,the patient was examined by imaging to observe the healing of the bone.Results A total of 48 patients completed the study.From the healing point of view,the fracture lines of all patients have healed,and no obvious fracture line can be observed from the reading.In the surgical comparison,the time spent on surgery in the observation group was(76.80±10.98)min,and that in the control group was(78.16±9.87)min;there was no significant difference between the two groups(P>0.05).From the postoperative hospital stay,the hospitalization time of the observation group was(14.28±0.85)d,and that of the control group was(14.61±1.16)d;there was no significant difference between the two groups(P>0.05).From the score of Broberg and Morrey,the score of the observation group was(88.79±4.27),which was significantly higher than(81.60±5.75)of the control group(P<0.05).From the perspective of elbow joint mobility,the elbow flexion angle,pre-rotation angle,forearm supination angle of the observation group were(131.26±0.87)°,(83.21±2.90)°,(84.92±2.33)°,respectively,which were significantly higher than corresponding(118.63±5.27)°,(75.12±3.81)°,(74.31±2.67)°of the control group(all P<0

关 键 词：桡骨小头骨折 内固定 加压螺钉 临床效果 接骨板 

分 类 号：R683.41[医药卫生—骨科学]