肘关节复杂骨折中动力型外固定支架的应用效果及随访分析  

Application effect and long-term follow-up analysis of dynamic external fixator for complex fracture of elbow joint

作　　者：李运进 黄平[1] 黄东永[1] 张燕青[1] 叶小燕[1] LI Yun-jin;HUANG Ping;HUANG Dong-yong;ZHANG Yan-qing;YE Xiao-yan(Department of Trauma Orthopedics,the Third People′s Hospital of Huizhou,Guangdong Province,Huizhou 516000,China)

机构地区：[1]广东省惠州市第三人民医院创伤骨科

出　　处：《河北医科大学学报》2020年第2期149-153,共5页Journal of Hebei Medical University

基　　金：惠州市医疗卫生类科技计划项目(2017Y142)

摘　　要：目的探讨肘关节复杂骨折中动力型外固定支架的应用效果。方法将60例过肘关节骨折患者随机分为对照组和试验组各30例。试验组应用内固定钢板螺钉钢丝加外固定动力型支架,对照组应用内固定钢板螺钉钢丝加外固定支架,比较2组术后1个月视觉模拟评分法(Visual Analogue Scale,VAS)评分、手术时间、骨折愈合时间,骨不愈合率和手术并发症发生情况,以及术后随访1个月、3个月、6个月、12个月Mayo肘关节功能评分结果。结果试验组VAS评分、骨折愈合时间均明显短于对照组(P<0.05),而2组手术时间、骨不愈合率差异均无统计学意义(P>0.05);2组术后Mayo肘关节功能评分均呈逐渐升高趋势,但试验组升高幅度大,2组Mayo肘关节功能评分在组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05);2组术后3个月手术并发症发生率差异无统计学意义(P>0.05)。结论外动力型固定支架用于过肘关节复杂型骨折效果更佳,可明显改善肘关节功能,减少骨折愈合时间,降低VAS评分,Mayo肘关节功能评分更高,值得临床推广应用。Objective To evaluate the application effect of dynamic external fixation in elbow fractures.Methods Sixty patients with hyperelbow fracture were randomly divided into control group and experimental group with 30 cases in each group.Internal fixation plate screw wire and external fixator were used in the experimental group and the control group was fixed with internal fixation steel plate screw wire and external fixator.Visual Analogue Scale(VAS)score,operation duration time,fracture healing time,bone nonunion in 1 month after operation were compared.Mayo elbow function scores were followed-up at 1,3,6 and 12 months and scores were compared between two groups.Results VAS score and fracture healing time of the experimental group were significantly shorter than those of the control group(P<0.05),and there were no statistically significant differences in operation duration time and bone nonhealing rate between two groups(P>0.05).The elbow function scores of the two groups showed a gradually increasing trend after surgery,but there was a large increase in the experimental group.The Mayo elbow function score of the two groups showed statistically significant differences in the interaction of groups,time points and between groups and time points(P<0.05).There was no significant difference in the incidence of surgical complications between two groups within 3 months after surgery(P>0.05).Conclusion The application effect of external dynamic fixed stent for complex fracture of elbow joint is better,which can significantly improve the function of the elbow,reduce the healing time of the fracture,reduce the VAS score and make Mayo elbow function score higher.It is worthy of clinical promotion and application.

关 键 词：肘关节 骨折固定术 预后 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学] R687.3[医药卫生—基础医学]