顺行扩髓交锁髓内钉治疗老年骨质疏松性肱骨近端骨折Neer Ⅱ、Ⅲ型的临床效果  

Clinical Efficacy of Anterograde Reaming Interlocking Intramedullary Nail in the Treatment of Senile Osteoporotic Proximal Humerus Fracture Neer Ⅱ and Ⅲ

作　　者：马文虎 师磊 李耿 郝亚斌 秦卫兵 闫波 权威 MA Wenhu;SHI Lei;LI Geng;HAO Yabin;QIN Weibing;YAN Bo;QUAN Wei(Department of Orthopedics I,the Third People´s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang Uygur Autonomous Region,830001 China)

机构地区：[1]新疆维吾尔自治区第三人民医院骨一科,新疆乌鲁木齐830001

出　　处：《世界复合医学》2023年第3期1-4,共4页World Journal of Complex Medicine

摘　　要：目的探究顺行扩髓交锁髓内钉治疗老年骨质疏松性肱骨近端骨折Neer Ⅱ、Ⅲ型的临床效果。方法选择2020年5月—2022年3月新疆维吾尔自治区第三人民医院收治的150例老年骨质疏松性肱骨近端骨折Neer Ⅱ、Ⅲ型患者为研究对象,应用随机数表法将其分为两组,各75例,对照组患者给予传统切口复位内固定进行治疗,研究组患者给予顺行扩髓交锁髓内钉治疗,对比两组患者手术时间、术中出血量、VAS评分等指标。结果研究组手术时间、术中出血量以及愈合时间均低于对照组,差异有统计学意义(t=7.429、6.401、3.767,P<0.05)。两组患者术后TNF-α、IL-6、MDA显著降低,SOD显著升高,且术后研究组TNF-α、IL-6、MDA低于对照组,SOD高于对照组,差异有统计学意义(t=6.728、11.082、47.566、18.748,P<0.05)。研究组患者并发症发生率(5.33%)低于对照组(16.00%),差异有统计学意义(χ^(2)=4.511,P<0.05)。研究组术后1个月、3个月VAS评分低于对照组,差异有统计学意义(P<0.05)。结论顺行扩髓交锁髓内钉治疗老年骨质疏松性肱骨近端骨折Neer Ⅱ、Ⅲ型可有效减少患者恢复时间,加强对肩功能的修复,同时降低炎症和氧化应激反应,降低疼痛感,具备一定程度的安全性。Objective To explore the clinical efficacy of anterograde reaming interlocking intramedullary nail in the treatment of senile osteoporotic proximal humerus fracture Neer Ⅱ and Ⅲ.Methods A total of one hundred and fifty elderly patients with osteoporotic proximal humerus fracture Neer Ⅱ and Ⅱ admitted to the Third People's Hospital of Xinjiang Uygur Autonomous Region from May 2020 to March 2022 were selected as the study objects,and randomly divided into two groups with seventy-five cases in each group by random number method.The control group was treated with traditional incision reduction and internal fixation,and the study group was treated with anterograde reaming interlocking intramedullary nail.The operation time,intraoperative blood loss and other indexes were compared between the two groups.Results The operation time,intraoperative blood loss and healing time of the study group were lower than those of the control group,and the difference was statistically significant(t=7.429,6.401,3.767,P<0.05).Postoperative TNF-α,IL-6 and MDA were significantly decreased,while SOD was significantly increased in the two groups,and postoperative TNF-α,IL-6 and MDA in the study group were lower than the control group,while SOD was higher than the control group,the difference was statistically significant(t=6.728,11.082,47.566,18.748,P<0.05).The incidence of complications in the study group(5.33%)was lower than that in the control group(16.00%),and the difference was statistically significant(χ^(2)=4.511,P<0.05).The VAS scores of the study group were lower than those of the control group at 1 and 3 months after surgery,and the difference was statistically significant(P<0.05).Conclusion In the treatment of senile osteoporotic proximal humerus fracture Neer Ⅱ and Ⅲ,the anterograde reaming interlocking intramedullary nail can effectively reduce the recovery time of patients,enhance the repair of shoulder function,reduce inflammation and oxidative stress response,and reduce pain,with a certain degree of safety.

关 键 词：顺行扩髓交锁髓内钉 老年骨质疏松性肱骨近端骨折 疼痛 术后恢复 

分 类 号：R68[医药卫生—骨科学]