肱骨近端锁定钢板与解剖钢板治疗老年粉碎性肱骨外科颈骨折的效果比较  

Comparison of locking proximal humerus plate and anatomical plate in the treatment of humerus surgical neck fractures in the elderly

作　　者：陈磊 刘洋 李超[2] Chen Lei;Liu Yang;Li Chao(Department of Orthopedics,No.990 Hospital of Joint Logistics Support Force,Xinyang 464000;Department of Bone and Soft Tissue,Henan Cancer Hospital,Zhengzhou 450000)

机构地区：[1]联勤保障部队第九九〇医院骨科,信阳464000 [2]河南省肿瘤医院骨与软组织科,郑州450000

出　　处：《中国临床实用医学》2022年第3期28-31,共4页China Clinical Practical Medicine

摘　　要：目的比较肱骨近端锁定钢板(LPHP)与解剖钢板治疗老年粉碎性肱骨外科颈骨折(HSNF)患者的效果。方法本研究为前瞻性研究,选取2019年1月至2021年7月联勤保障部队第九九〇医院骨科收治的104例粉碎性HSNF患者,男56例,女48例,年龄(67.34±3.77)岁,年龄范围为60~74岁。采用随机数表法将所有患者随机分为LPHP组和解剖钢板组,每组52例。LPHP组患者接受LPHP治疗,解剖钢板组患者接受解剖钢板治疗。比较两组患者的治疗效果、围术期指标、肩关节Constant-Murley评分、视觉模拟评分法(VAS)评分、成骨相关因子指标[骨形态发生蛋白-7(BMP-7)、碱性成纤维细胞因子(bFGF)]。结果LPHP组优良率[98.1%(51/52)]高于解剖钢板组[84.6%(44/52)],差异有统计学意义(P<0.05)。LPHP组术中失血量[(208.77±17.56)ml]少于解剖钢板组[(274.16±22.43)ml],手术时间、住院时间及骨折愈合时间[(71.81±9.41)min、(12.62±1.81)d、(84.76±13.25)d]均短于解剖钢板组[(86.62±13.67)min、(14.74±2.26)d、(112.76±20.35)d],差异均有统计学意义(P<0.05)。LPHP组术后1个月、术后3个月的肩关节Constant-Murley评分[(72.15±3.30)分、(86.58±5.27)分]均高于解剖钢板组[(68.24±3.04)分、(80.34±4.43)分],差异有统计学意义(P<0.05)。LPHP组术后1个月、术后3个月的VAS评分[(3.32±0.35)分、(1.36±0.26)分]均低于解剖钢板组[(4.25±0.63)分、(2.33±0.39)]分,差异有统计学意义(P<0.05)。LPHP组者术后3个月bFGF、BMP-7水平[(69.22±8.51)pg/L、(138.34±21.03)pg/L]高于解剖钢板组[(62.13±8.06)pg/L、(120.57±14.71)pg/L],差异有统计学意义(P<0.05)。结论LPHP治疗HSNF比解剖钢板治疗,在提升手术效果、优化围术期指标、改善肩关节功能、缓解疼痛感、促进骨折愈合方面更具优势。Objective To investigate the effect of locking proximal humerus plate(LPHP)and anatomical plate in the treatment of elderly patients with comminuted humeral surgical neck fracture(HSNF)in the elderly.Methods This article was a prospective study.A total of 104 patients with comminuted HSNF who were admitted to the Department of Orthopedics of the No.990 Hospital of the Joint Logistics Support Force from January 2019 to July 2021 were selected,including 56 males and 48 females with an age(67.34±3.77)years old,and the age ranged from 60 to 74 years old.All patients were randomly divided into the LPHP group and the anatomical plate group by random number table method,52 cases in each group.Patients in the LPHP group received LPHP,and patients in the anatomical plate group received anatomical plate treatment.The treatment effect,perioperative indicators,Constant-Murley score of shoulder joint,visual analog scale(VAS)score,osteogenesis-related factor indicators[bone morphogenetic protein-7(BMP-7),basic Fibrocytokine(bFGF)]were compared.Results The excellent and good rate in the LPHP group[98.1%(51/52)]was higher than that in the anatomical plate group[84.6%(44/52)],and the difference was statistically significant(P<0.05).The intraoperative blood loss in the LPHP group was less than that in the anatomical plate group,the operation time,the hospital stay and the fracture healing time were shorter than those in the anatomical plate group,and the differences were statistically significant(P<0.05).The Constant-Murley scores of the shoulder joint at 1 month and 3 months after the operation in the LPHP group were higher than those in the anatomical plate group,the difference was statistically significant(P<0.05).The VAS scores in the LPHP group at 1 month and 3 months after the operation were lower than those in the anatomical plate group,and the difference was There was statistical significance(P<0.05).The levels of bFGF and BMP-7 in the LPHP group at 3 months after surgery were higher than those in the anatomical plate gro

关 键 词：肱骨外科颈粉碎性骨折 锁定钢板 解剖钢板 

分 类 号：R687.3[医药卫生—骨科学]