自体髂骨植骨联合锁定钢板内固定治疗肱骨近端骨折的临床效果  

Effect of Autogenous Iliac Bone Graft Combined with Locking Plate Internal Fixation in the Treatment of Proximal Humeral Fractures

作　　者：李青 LI Qing(Department of Orthopedics,Zichuan District Hospital,Zibo City,Zibo 255100,China)

机构地区：[1]淄博市淄川区医院骨科,山东淄博255100

出　　处：《中国医药指南》2023年第6期22-25,共4页Guide of China Medicine

摘　　要：目的 探讨自体髂骨植骨联合锁定钢板内固定治疗肱骨近端骨折的临床效果。方法 选择2019年7月至2021年8月本院收治的肱骨近端骨折患者80例为研究对象。按照随机数字表法分为两组,各40例。所有入组者均于臂丛麻醉联合喉罩全身麻醉下完成手术,观察组行自体三面皮质骨髂骨植骨、肱骨近端锁定钢板手术,对照组仅实施锁定钢板治疗,比较两组术后住院时间和骨折愈合时间,比较两组术后随访6个月时肩关节活动度,比较两组术后3个月和术后6个月Neer肩关节功能评分,统计两组术后并发症总发生率。结果 观察组术后住院时间为(7.41±2.32)d,短于对照组(P <0.05);骨折愈合时间为(11.72±3.22)周,快于对照组(P <0.05);术后6个月随访时,观察组肩关节活动度中的背伸角度为(38.40±2.91)°,前屈角度为(85.62±5.83)°,内收角度为(35.54±3.80)°,外展角度为(85.21±7.62)°,内旋角度为(68.53±11.94)°,外旋角度为(52.70±6.81)°,其均大于对照组(P <0.05)。术后3个月和术后6个月,观察组Neer肩关节功能评分分别为(46.80±11.70)分和(77.81±15.11)分,均明显高于对照组(P <0.05),且术后6个月,两组Neer肩关节功能评分均高于术后3个月(P <0.05)。观察组术后出现肱骨面骨质吸收、螺钉松动、畸形愈合和骨不连的总比例为5.00%,显著低于对照组的32.50%(P <0.05)。结论 针对肱骨近端骨折者使用自体髂骨植骨结合锁定钢板内固定治疗,能显著缩短患者住院时间,促进骨折愈合,提高肩关节功能,且术后并发症少,安全性高。Objective To explore the clinical effect of autogenous iliac bone graft combined with locking plate internal fixation in the treatment of proximal humeral fractures. Methods Eighty cases with proximal humeral fractures admitted in our hospital from July 2019 to August 2021were randomly divided into two groups, 40 cases each. All the patients in the group completed the operation under brachial plexus anesthesia combined with laryngeal mask anesthesia. The observation group was treated with autologous triple cortical bone graft and locking plate in proximal humerus, while the control group was treated with locking plate only. The postoperative hospitalization time and fracture healing time of the two groups were compared, the shoulder joint mobility of the two groups was compared during the 6-month follow-up, the Neer shoulder joint function scores of the two groups were compared at 3 months and 6 months after operation, and the total incidence of postoperative complications was counted. Results The postoperative hospitalization time of the observation group was(7.41±2.32) days, which was shorter than that of the control group(P<0.05). The fracture healing time was(11.72±3.22) weeks, which was faster than that of the control group(P<0.05). At the 6-month follow-up after surgery, the dorsiflexion angle in the range of motion of the shoulder joint in the observation group was(38.40±2.91)°, the forward flexion angle was(85.62±5.83)°, the adduction angle was(35.54±3.80)°, the abduction angle was(85.21±7.62)°, the internal rotation angle was(68.53±11.94)°, and the external rotation angle was(52.70±6.81)°, which were greater than those of the control group(P<0.05). At 3 months and 6 months after operation, Neer’s shoulder joint function scores in the observation group were(46.80±11.70) and(77.81±15.11) respectively, which were significantly higher than those in the control group(P<0.05). The scores of Neer shoulder joint function in both groups were higher than those in 3 months after operation(P<0.05).

关 键 词：自体髂骨植骨 锁定钢板内固定 肱骨近端骨折 肩关节功能 并发症 

分 类 号：R683.41[医药卫生—骨科学]