闭合复位髓内钉与切开复位锁定钢板治疗肱骨近端骨折的临床疗效对比  

Comparison of the Clinical Efficacy for Closed Reduction Intramedullary Nail and Open Reduction Locking Plate in the Treatment of Proximal Humerus Fracture

作　　者：闫光华 史彤 张军华 杨伟正 杜慧斌 李园鹏 薛庆 韩博 张晓辉 YAN Guang-hua;SHI Tong;ZHANG Jun-hua;YANG Wei-zheng;DU Hui-bin;LI Yuan-peng;XUE Qing;HAN Bo;ZHANG Xiao-hui(Department of Orthopedics,Yanhu District Branch,the First Hospital of Shanxi Medical University,Yuncheng 044000,China)

机构地区：[1]山西医科大学第一医院盐湖区分院骨一科,山西运城044000

出　　处：《中国医药指南》2020年第20期10-12,共3页Guide of China Medicine

摘　　要：目的比较闭合复位髓内钉内固定术与切开复位锁定钢板内固定术治疗肱骨近端骨折的临床疗效。方法回顾性分析2017年5月至2019年5月我科收治的93例肱骨近端骨折患者资料,随机分为髓内钉组48例、钢板组45例。比较两组患者手术时间、术中出血量、手术切口及骨折愈合时间,在骨折愈合后及术后6个月分别采用Constant-Murley评分评估肩关节功能。结果两组患者获得12~48个月随访,平均(20.03±4.35)个月。两组手术时间、术中出血量及手术切口长度、骨折愈合时肩关节功能Constant-Murley评分比较差异均有统计学意(P <0.05)。骨折愈合时间、术后6个月肩关节功能Constant-Murley评分比较差异无统计学意义(P> 0.05)。结论闭合复位髓内钉内固定与切开复位钢板内固定治疗肱骨近端骨折术后短期内肩关节功能差异明显,远期肩关节功能差异不明显。髓内钉内固定术创伤小、可早期恢复肩关节功能,值得临床推广。Objective To compare the clinical efficacy of two surgical methods for the treatment of proximal humerus fracture:closed reduction and intramedullary nailing and open reduction and locking plate internal fixation.Methods The data of 93 patients with proximal humerus fracture treated in our department from May 2017 to May 2019 were analyzed retrospectively.They were divided into closed reduction intramedullary nail fixation group(48 cases) and open reduction locking plate internal fixation group(45 cases).The operation time,intraoperative bleeding volume,surgical incision and fracture healing time were compared between the two groups.The function of shoulder joint was evaluated by Constant-Murley score after fracture healing and 6 months after operation.Results Two groups of patients received 12-48 months of follow-up,with an average of(20.03±4.35) months.The operative time,intraoperative bleeding volume and length of surgical incision,and shoulder function Constant-Murley score were statistically different between the two groups(P<0.05).And the fracture healing time,the shoulder function Constant-Murley score comparison was not statistically significant in the operation 6 months later(P>0.05).Conclusion There was significant difference in shoulder joint function between clo sed reduction intramedullary nail internal fixation and open reduction locking plate internal fixation in the short term after treatment of proximal humerus fracture,but no significant difference in long-term shoulder joint function.Intramedullary nail fixation has less trauma and can re store shoulder function early,which is wo rthy of clinical promotion.

关 键 词：肱骨近端骨折 髓内钉 锁定钢板 临床疗效 

分 类 号：R683.41[医药卫生—骨科学]