切开复位内固定术与经皮微创接骨术治疗Neer分型Ⅲ~Ⅳ部分肱骨骨折患者的临床疗效对比  

Clinical efficacy of open reduction and internal fixation versus minimally invasive percutaneous plate osteosynthesis for treating Neer′s typeⅢandⅣhumerus fracture:a comparative study

作　　者：彭辉[1] 庄小强[1] 白宇[1] 方旭[1] 黄晖[1] 陆生林[1] PENG Hui;ZHUANG Xiao-qiang;BAI Yu;FANG Xu;HUANG Hui;LU Sheng-lin(Department of Orthopedics,Affiliated Minzu Hospital of Guangxi Medical University,Nanning 530001,China)

机构地区：[1]广西医科大学附属民族医院骨科,南宁市530001

出　　处：《广西医学》2020年第14期1779-1782,共4页Guangxi Medical Journal

基　　金：广西崇左市科技计划(崇科攻2018010)。

摘　　要：目的观察传统切开复位内固定术(ORIF)与经皮微创接骨术(MIPPO)治疗Neer分型Ⅲ~Ⅳ部分肱骨骨折患者的临床疗效差异。方法将150例Neer分型Ⅲ~Ⅳ部分骨折患者分为研究组和对照组,每组75例。对照组患者采用ORIF治疗,研究组患者采用MIPPO治疗。比较两组患者手术时间、术中出血量、术后住院时间、骨折愈合时间、术后并发症发生情况,以及两组患者术后3个月随访肩关节功能Neer评分和手术前后疼痛视觉模拟量表(VAS)评分。结果研究组手术时间、骨折愈合时间均短于对照组,术中出血量及术后并发症发生率均低于对照组,术后3个月肩关节功能Neer评分优良率高于对照组(均P<0.05),而两组术后住院时间比较,差异无统计学意义(P>0.05)。术后3个月,两组患者VAS评分均低于术前,且研究组低于对照组(均P<0.05)。结论与采用ORIF相比,采用MIPPO治疗Neer分型Ⅲ~Ⅳ部分肱骨骨折的手术时间及骨折愈合时间更短,术中出血量更少,术后并发症发生率更低,更有利于减轻患者疼痛及促进肩关节功能恢复。Objective To observe the clinical efficacy of traditional open reduction and internal fixation(ORIF)versus minimally invasive percutaneous plate osteosynthesis(MIPPO)for the treatment of Neer′s typeⅢandⅣhumerus fracture.Methods A total of 150 patients with Neer′s typeⅢandⅣhumerus fracture were divided into study group and control group,with 75 cases in each group.Patients in the control group were treated with ORIF,while patients in the study group were treated with MIPPO.Operation duration,intraoperative blood loss,postoperative hospital stay,fracture healing time,and incidence of postoperative complications were compared between the two groups,and the Neer score of shoulder joint function at month 3 postoperatively and the Visual Analogue Scale(VAS)scores before and after operation were compared between the two groups as well.Results The study group exhibited shorter operation duration and fracture healing time,less intraoperative blood loss,lower incidence rate of postoperative complications,and higher excellent and good rate on Neer score of shoulder joint function at month 3 postoperatively as compared with the control group(all P<0.05),but there was no statistically significant difference in postoperative hospital stay between the two groups(P>0.05).Three months after operation,VAS scores were decreased in both groups than the preoperative scores,and the the study group had lower scores than the control group(all P<0.05).Conclusion Compared with ORIF,the use of MIPPO has shorter operation duration and fracture healing time,less intraoperative bleeding,and lower incidence rate of postoperative complications in the treatment of Neer′s typeⅢandⅣhumerus fracture,which is more conducive to ameliorating patients′pain and promoting shoulder joint function recovery.

关 键 词：肱骨骨折 Neer分型Ⅲ~Ⅳ部分 切开复位内固定术 经皮微创接骨术 肩关节功能 疗效 

分 类 号：R683.413[医药卫生—骨科学]