肩峰外下小切口在中老年肱骨近端三部分骨折ERAS中的应用  

Application of small external inferior acromial incision in ERAS of three-part proximal humerus fractures in middle-aged and elderly patients

作　　者：孙晓亮 张结合[1] 官建中[2] SUN Xiaoliang;ZHANG Jiehe;GUAN Jianzhong(Department of Traumatic Orthopedics,Xinhua Hospital of Huainan Xinhua Medical Group,Huainan 232052,Anhui,China;Department of Orthopaedics,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China)

机构地区：[1]淮南新华医疗集团新华医院创伤科,安徽省淮南市232052 [2]蚌埠医学院第一附属医院骨科,安徽省蚌埠市233004

出　　处：《中南医学科学杂志》2022年第4期536-539,共4页Medical Science Journal of Central South China

基　　金：安徽省科技攻关项目(1604a0802090)。

摘　　要：目的探讨肩峰外下小切口在中老年肱骨近端三部分骨折加速康复外科(ERAS)中的应用。方法中老年肱骨近端三部分骨折手术患者31例,分为小切口组15例和普通手术组16例。比较两组手术相关指标(手术切口、手术时间、出血量、住院时间、术后骨痂形成时间、并发症),以及手术前后疼痛视觉模拟评分(VAS)、Constant-Murley肩关节功能评分和肩关节活动度。结果小切口组切口长度、手术时间、住院时间、术中出血量、术后骨痂形成时间均小于普通手术组(P<0.05);术后3个月、6个月肩关节功能评分及VAS评分优于普通手术组(P<0.05),术后12个月评分差异无显著性(P>0.05);两组术后并发症比较差异无显著性(P>0.05)。结论肩峰外下小切口治疗中老年肱骨近端三部分骨折安全有效,在ERAS中有应用价值。Aim To evaluate the application value of the technique in ERAS,pull-up reduction combined with the small external inferior acromial incision was applied in the operation of three-part proximal humerus fracture in middle-aged and elderly patients.Methods 31 middle-aged and elderly patients with three part proximal humeral fracture were divided into small incision group(15 cases)and ordinary operation group(16 cases).The operation related indexes(surgical incision,operation time,bleeding volume,hospital stay,postoperative callus formation time,complications),pain visual analog score(VAS),constant Murley shoulder function score and shoulder range of motion before and after operation were compared between the two groups.Results The incision length,operation time,hospital stay,intraoperative bleeding and postoperative callus formation time in the small incision group were lower than those in the general operation group(P<0.05);The shoulder function score and VAS score of 3 and 6 months after operation were better than those of the ordinary operation group(P<0.05),and there was no significant difference in vas at 12 months after operation(P>0.05);There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion In the treatment of three-part proximal humerus fractures in the middle-aged and elderly,the mininally invasive is safe and effective,and has application value in ERAS.

关 键 词：肩峰外下小切口 中老年 肱骨近端三部分骨折 ERAS 

分 类 号：R683.41[医药卫生—骨科学]