带线锚钉与钢板内固定治疗肱骨大结节骨折的优劣分析  

Advantages and disadvantages of internal fixation with suture anchors and locking plate in the treatment of the greater tuberosity fracture

作　　者：王强 顾勇[2] 陈亮[2] Wang Qiang;Gu Yong;Chen Liang(Suzhou Dushuhu Public Hospital,Suzhou 215000,Jiangsu Province,China;The First Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu Province,China)

机构地区：[1]苏州市独墅湖医院,江苏省苏州市215000 [2]苏州大学附属第一医院,江苏省苏州市215000

出　　处：《中国组织工程研究》2020年第30期4813-4817,共5页Chinese Journal of Tissue Engineering Research

基　　金：苏州市临床重点病种诊疗技术专项(LCZX201701),项目负责人:陈亮。

摘　　要：背景:手术治疗肱骨大结节骨折目前普及切开复位钢板螺钉固定,但存在着一些不足。目的:比较切开复位带线锚钉与切开复位钢板内固定治疗肱骨大结节骨折的疗效。方法:回顾性分析2016年1月至2018年12月苏州大学附属第一医院收治的肱骨大结节骨折33例患者的资料,根据内固定方式分为锚钉组(n=7)和钢板组(n=26),分别行切开复位带线锚钉和切开复位钢板螺钉内固定。统计比较2组患者手术时间、切口长度、术中失血量、术后骨折块再移位距离及术后1个月、3个月、末次随访肩关节功能Constant-Murle评分,并记录2组内固定的不良反应情况。结果与结论:①锚钉组手术时间(73.1±10.5)min短于钢板组(98.2±11.9)min,切口长度(7.3±1.1)cm小于钢板组(14.9±1.7)cm,术中失血量(45.0±7.1)m L小于钢板组(141.0±25.9)mL,差异均有显著性意义(P<0.05);②锚钉组术后骨折块再移位距离(3.0±1.8)mm大于钢板组(1.1±2.3)mm,差异有显著性意义(P<0.05);③术后1,3个月及末次随访时,2组之间Constant-Murle评分比较,差异均无显著性意义(P>0.05);④提示与切开复位钢板内固定相比,切开复位带线锚钉内固定治疗肱骨大结节骨折具有手术时间短、创伤小的优势。BACKGROUND:Open reduction and internal fixation with locking plate is wildly used in treatment of the greater tuberosity fracture,but certain disadvantages still existed.OBJECTIVE:To compare the effects of open reduction and internal fixation with suture anchors and locking plate in the treatment of the greater tuberosity fracture.METHODS:A retrospective review of 33 patients with greater tuberosity fracture treated with open reduction and internal fixation between January 2016 and December 2018 was conducted.According to internal fixation method,the patients were divided into anchor group(n=7)and plate group(n=26),which received open reduction+suture anchor fixation and open reduction+locking plate fixation.Operation time,incision length,intraoperative blood loss,postoperative displacement of fracture mass,and Constant-Murley score 1 and 3 months after surgery and in final follow-up were compared between the two groups.Adverse reactions were recorded in the two groups.RESULTS AND CONCLUSION:(1)Operation time was shorter in the anchor group(73.1±10.5 minutes)than in the plate group(98.2±11.9 minutes).Incision length was shorter in the anchor group(7.3±1.1 cm)than in the plate group(14.9±1.7 cm).Intraoperative blood loss was less in the anchor group(45.0±7.1 mL)than in the plate group(141.0±25.9 mL)(P<0.05).(2)Postoperative displacement of fracture mass was larger in the anchor group(3.0±1.8 mm)than in the plate group(1.1±2.3 mm)(P<0.05).(3)There was no significant difference in Constant-Murley score between the two groups 1 and 3 months after surgery and in final follow-up(P>0.05).(4)All results suggest that compared with locking plate fixation,suture anchor fixation is easier to be operated with small trauma in the treatment of the greater tuberosity fracture.

关 键 词：骨 骨折 内固定 钢板 带线锚钉 肱骨 移位 随访 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]