LCP内固定治疗肱骨近端骨折的疗效及对肱骨颈干角重建的临床研究  

Clinical efficacy of LCP internal fixation for proximal humerus fracture and reconstruction of humeral neck-shaft angle

作　　者：周树良 朱建炜[2] Zhou Shu-liang;Zhu Jian-wei(Suzhou Ninth People's Hospital,Suzhou 215200,China;Affiluited Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]苏州市第九人民医院,苏州215200 [2]南通大学附属医院关节外科,南通2226001

出　　处：《湖南师范大学学报（医学版）》2021年第1期36-39,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：南通市科技项目(NO.JC2018055)。

摘　　要：目的:探讨锁定加压钢板(locking compression plate)LCP内固定治疗肱骨近端骨折的疗效及对肱骨颈干角重建的影响。方法:回顾性分析2016年1月~2017年12月在上海市静安区闸北中心医院手术治疗的60例肱骨近端骨折患者的临床病历资料,所有患者均采用LCP进行手术治疗,依据术后患者不同的股骨颈干角可分为正常重建组(42例)和内翻复位组(18例),术后对所有患者进行为期12个月的随访跟踪,比较两组患者的骨折愈合时间、颈干角变化、肩关节功能Constant评分和疼痛视觉模拟(VAS)评分、临床疗效还有并发症发生情况。结果:随访结束后,正常重建组患者的骨折愈合时间(3.38±0.51)月明显短于内翻复位组(3.59±0.47)月,股骨头内翻角(1.71±2.63)°明显小于内翻复位组(4.19±4.57)°;正常重建组Constant评分(77.82±10.51)分明显高于内翻复位组(70.88±11.47)分,VAS评分(1.61±2.63)分明显低于内翻复位组(2.98±1.57)分;正常重建组患者优良率(78.57%)明显高于内翻复位组(50.00%);正常重建组患者并发症发生率(14.29%)明显低于内翻复位组(38.89%),差异比较有统计学意义。结论:LCP内固定治疗肱骨近端骨折临床疗效好,维持肱骨颈干角重建能够加强内固定稳定,优良率高,并且并发症少,值得临床推广与应用。Objective To explore the efficacy of LCP internal fixation for the treatment of proximal humeral fractures and the clinical study of reconstruction of the humeral neck dry angle,to provide guidance for patients.Methods The clinical data of 60 patients with proximal humeral fracture who were operated in Zhabei Central Hospital,Jing’an District,Shanghai from January 2016 to December 2017 were analyzed retrospectively.All patients underwent surgical treatment with a locking compression plate (LCP).The patients were treated with different femoral neck-shaft angles which were divided into normal reconstruction group (n=42) and varus reduction group (n=18).After 12 months of follow-up,the fracture healing time,the changes of neck-shaft angle,constant shoulder scores,the visual analog cale (VAS) score,clinical efficacy and complications were compared between the two groups for analysis.Results At the end of follow-up,the fracture healing time was lower in the normal reconstruction group (3.38±0.51) months than in the varus reduction group (3.59±0.47) months,and the femoral head varus angle (1.71±2.63) ° was significantly smaller than the varus reduction group (4.19±4.57) °.The normal score of the normal reconstruction group (77.82±10.51) was significantly higher than that of the varus reduction group (70.88±11.47),and the VAS score (1.61±2.63) was significantly lower than the varus reduction group (2.98±1.57).The excellent rate of patients in the normal reconstruction group (78.57%) was significantly higher than that in the varus reduction group (50.00%).The incidence of complications in the normal reconstruction group (14.29%) was significantly lower than that in the varus reduction group (38.89%) and the difference between the two groups was statistically significant.Conclusion LCP internal fixation for the treatment of proximal humeral fractures has good clinical effecacy and reduce complications.The reconstruction of the humeral neck-shaft angle can enhance the stability of internal fixation and it is wo

关 键 词：股骨近端骨折 锁定接骨板 颈干角重建 内固定 疗效 

分 类 号：R687.3[医药卫生—骨科学]