双排锚钉缝线桥与空心拉力螺钉治疗老年肱骨大结节骨折的疗效比较  

A Comparative Study on the Efficacy of Double-row Suture Anchor Bridge and Hollow Lag Screw in the Treatment of Elderly Patients with Greater Tuberosity Fracture

作　　者：白云鹏 邱永敏[1] 丁菊红[1] 沈燕国[1] 王健[1] Bai Yunpeng;Qiu Yongmin;Ding Juhong(Department of Orthopedics,Pudong New Area People's Hospital,Shanghai 201299,China)

机构地区：[1]上海市浦东新区人民医院骨科,上海201299

出　　处：《实用骨科杂志》2020年第8期682-687,共6页Journal of Practical Orthopaedics

基　　金：上海市浦东新区卫计委青年科技项目(PW2017B-20)。

摘　　要：目的比较双排锚钉缝线桥与空心拉力螺钉固定治疗老年单纯性肱骨大结节骨折的疗效。方法将2017年6月至2019年6月我院收治的40例60岁及以上老年单纯性肱骨大结节骨折,根据手术方式不同分为试验组(20例)和对照组(20例),其中试验组采用双排锚钉缝线桥固定,对照组采用多枚空心拉力螺钉固定。术后定期随访,记录并对比两组骨折愈合时间、末次随访时Constant-Murley肩关节功能评分、疼痛视觉模拟评分(visual analogue scale,VAS)、术后并发症及二次手术率。结果40例患者获得随访12~24个月,平均(14.9±1.5)个月,骨折均骨性愈合。愈合时间试验组(7.9±2.3)周,对照组(8.5±3.1)周,两组比较差异无统计学意义(P>0.05)。末次随访时试验组Constant-Murley肩关节功能评分(89.4±11.2)分,对照组(80.3±8.9)分,两者比较差异有统计学意义(P<0.05)。末次随访时试验组VAS评分(0.6±0.4)分,对照组(1.4±1.2)分,两者比较差异有统计学意义(P<0.05)。术后试验组感染1例,对照组2例(P>0.05);试验组骨折再移位0例,对照组6例(P<0.05);试验组肩峰撞击征0例,对照组4例(P<0.05);试验组二次手术0例,对照组10例(P<0.05)。结论双排锚钉缝线桥技术治疗老年肱骨大结节骨折固定充分且牢靠,相比空心拉力螺钉固定可有效提高肩关节功能预后,降低并发症发生率及二次手术率。Objective To compare the efficacy of double-row suture anchor bridge and hollow lag screw fixation in the treatment of elderly patients with isolatedgreater tuberosity fracture.Methods From June 2017 to June 2019,40 cases of isolatedgreater tuberosity fracture aged 60 years and over were treated in our hospital.They were divided into trial group(20 cases)and control group(20 cases)according to different fixation methods.The trial group was fixed with double-row suture anchor bridge,while the control group was fixed with multiple hollow lag screws.The time of fracture union,Constant-Murley score and visual analog scale(VAS)at the last follow-up,postoperative complications and secondary surgery rate were recorded and compared between the two groups.Results 40 patients were followed up for 12~24 months,with an average of(14.9±1.5)months.All patientshad fracture union.The union time was(7.9±2.3)weeks in the trial group and(8.5±3.1)weeks in the control group.There was no significant difference between the two groups(P>0.05).At the last follow-up,Constant-Murley score was(89.4±11.2)in the trial group and(80.3±8.9)points in the control group.There was a significant difference between the two groups(P<0.05).At the last follow-up,the VAS score of the trial group was(0.6±0.4)and the control group was(1.4±1.2)(P<0.05).Postoperative infection was observed in 1 case in the trial group and 2 cases in the control group(P>0.05).Re-displacement was observed in 0 cases in the trial group and 6 cases in the control group(P<0.05);impingement syndrome was observed in 0 cases in the trial group and 4 cases in the control group(P<0.05);secondary surgery was performed in 0 cases in the trial group and 10 cases in the control group(P<0.05).Conclusion The double-row suture anchor bridge is an effective and reliable method in the treatment of elderly patients with greater tuberostiy fracture.Compared with hollow lag screw fixation,this method can effectively improve the shoulderfunction,and reduce the incidence of complications and

关 键 词：肱骨骨折 大结节 带线锚钉 空心拉力螺钉 

分 类 号：R683.41[医药卫生—骨科学]