肱骨近端多维带锁髓内钉治疗Neer2、Neer3部分老年肱骨外科颈骨折临床研究  

Clinical study of multi-dimensional interlocking intramedullary nailing for the proximal humerus in the treatment of Neer2 and Neer3 in the elderly with surgical neck fractures of the humerus

作　　者：李昱川 陈欣[1] 贾杉 周文 刘业广 Li Yuchuan;Chen Xin;Jia Shan;Zhou Wen;Liu Yeguang(Liuzhou Municipal Liutie Central Hospital of Guangxi,Liuzhou 545007,Guangxi,China)

机构地区：[1]广西柳州市柳铁中心医院,广西柳州545007

出　　处：《右江民族医学院学报》2022年第4期550-554,共5页Journal of Youjiang Medical University for Nationalities

摘　　要：目的研究肱骨近端多维带锁髓内钉治疗Neer2、Neer3部分老年肱骨外科颈骨折的临床疗效。方法回顾性研究自2019年1月—2021年6月柳铁中心医院共收治老年肱骨外科颈Neer2、Neer3部分骨折患者79例,按内固定方式分为两组,分别采用肱骨近端多维带锁髓内钉组(38例)和肱骨近端锁定钢板组(41例)进行固定。对比分析两组围手术期各项数据指标,术后随访通过影像学及查体检查患者肩关节功能恢复情况。结果髓内钉组手术时间、总出血量、骨折愈合时间均少于钢板组,透视次数及手术时间大于钢板组,差异具有统计学意义(P<0.05)。末次随访各项数据指标无明显差异:肱骨近端颈干角、肩关节的活动范围、视觉疼痛模拟VAS评分以及肩关节Constant-Murley评分差异无统计学意义(P>0.05)。结论肱骨近端多维带锁髓内钉及锁定钢板治疗Neer2、Neer3部分老年肱骨外科颈骨折均能达到良好的治疗效果,但髓内钉手术出血少,创伤小,骨折愈合快,是老年肱骨外科颈骨折手术治疗的理想内固定方式之一,值得临床推广。Objective To study the clinical efficacy of multi-dimensional interlocking intramedullary nailing for the proximal humerus in treating Neer2 and Neer3 of the elderly with surgical neck fractures of the humerus.Methods This study retrospectively analyzed 79 elderly patients with surgical neck fractures at Neer2 and Neer3 of the humerus and they were admitted to Liutie Central Hospital of Guangxi from January 2019 to June 2021.These patients were divided into two groups according to the methods of internal fixation:the multi-dimensional interlocking intramedullary nailing group(38 cases)and the locking steel plate group(41 cases).This study moved on to compare and analyze the perioperative indicators of these two groups.Postoperative follow-up was conducted to observe the recovery of shoulder joint function by means of imaging and physical examination.Results The operation duration,total blood loss and fracture healing time of the intramedullary nailing group were shorter than those of the steel plate group,but the intramedullary nailing group underwent more X-ray examinations with longer operation duration,so the differences were statistically significant(P<0.05).At the last follow-up,there were no significant differences in various indicators including the cervical trunk angle of the proximal humerus,the motion range of shoulder joint,the visual analog score(VAS)and the Constant-Murley score of shoulder joint(P>0.05).Conclusion The multidimensional interlocking intramedullary nailing for the proximal humerus and locking plate can achieve good results in the treatment of Neer2 and Neer3 in the elderly with surgical neck fractures of the humerus.However,intramedullary nailing has less bleeding,less trauma and faster fracture healing.It is one of the ideal internal fixation methods for treatment of surgical neck fractures of the humerus in the elderly and worthy of clinical promotion.

关 键 词：髓内钉 老年 肱骨外科颈骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]