LC-DCP联合皮质外骨桥对肱骨骨折患者术后骨不连及生活质量的影响  

Influences of LC-DCP combined with extracortical bone bridge on postoperative nonunion and quality of life in patients with humeral fracture

作　　者：刘峰 高扬 董海鹏 穆卫庐[1] 李炎[1] LIU Feng;GAO Yang;DONG Hai-peng(Department of Orthopaedic Trauma,Shijiazhuang Third Hospital,Shijiazhuang Hebei 050000,China)

机构地区：[1]石家庄市第三医院创伤骨科,河北石家庄050000

出　　处：《临床和实验医学杂志》2023年第9期957-961,共5页Journal of Clinical and Experimental Medicine

基　　金：石家庄市科学技术研究与发展计划项目(编号:201200733);河北省医学科研重点课题计划项目(编号:20150169)。

摘　　要：目的观察有限接触动力加压钢板内固定术(LC-DCP)联合皮质外骨桥对肱骨骨折患者术后骨不连及生活质量的影响。方法前瞻性选取2020年6月至2021年6月石家庄市第三医院及合作医院收治的肱骨骨折术后骨不连患者100例,将其按照随机数字表法分为对照组50例和研究组50例。对照组应用动力加压钢板(DCP)联合皮质外骨桥技术进行治疗,研究组应用LC-DCP联合皮质外骨桥技术进行治疗。比较两组的手术状况、骨折愈合时间、住院时间、肩/肘关节功能、生活质量、术后并发症与骨不连再发生率,并检测血清胰岛素样生长因子-1(IGF-1)、成纤维细胞生长因子-2(FGF-2)水平。结果研究组手术用时为(125.46±12.85)min,较对照组[(130.24±10.53)min]短,研究组术中出血量为(254.19±20.73)mL,较对照组[(262.86±18.62)mL]少,研究组骨折愈合时间、住院时间分别为(11.74±3.26)周、(14.23±1.76)d,较对照组[(13.15±3.34)周、(15.08±2.11)d]短,差异均有统计学意义(P<0.05)。研究组肩关节屈伸活动度为(132.26±4.46)°,大于对照组[(127.74±5.11)°],研究组Neer评分为(85.46±2.34)分,高于对照组[(80.78±3.23)分],研究组肩关节功能优良率为90.00%,高于对照组(70.00%),差异均有统计学意义(P<0.05)。研究组肘关节屈伸活动度为(132.26±4.46)°,大于对照组[(127.74±5.11)°],研究组Mayo评分为(85.46±2.34)分,高于对照组[(80.78±3.23)分],研究组肘关节功能优良率为98.00%,高于对照组(80.00%),差异均有统计学意义(P<0.05)。术后,2组的血清IGF-1、FGF-2水平均高于术前,且研究组分别为(28.82±5.18)ng/L、(417.18±8.32)ng/mL,分别较对照组高[(24.42±4.83)ng/L、(362.09±7.79)ng/mL],差异均有统计学意义(P<0.05)。研究组术后并发症总发生率为4.00%,与对照组(12.00%)比较,差异无统计学意义(P>0.05),骨不连再发生率为0,低于对照组(12.00%),差异有统计学意义(P<0.05)。术后,2组的EuroQoL健康指数量表(EQObjective To observe the influences of limited contact dynamic compression plate internal fixation(LC-DCP)combined with extracortical bone bridge on postoperative nonunion and quality of life in patients with humeral fractures.Methods From June 2020 to June 2021,100 patients with postoperative nonunion of humerus fractures treated in Shijiazhuang Third Hospital and cooperative hospital were gathered and divided into control group and study group according to the random number table.The control group,50 patients,were treated with dynamic compression plate(DCP)combined with extracortical bone bridge technology,and the study group,50 patients,were treated with LC-DCP combined with extracortical bone bridge technique.The operation status,fracture healing time,hospital stay,shoulder/elbow joint function,quality of life,postoperative complications and nonunion rates were compared,and the levels of serum insulin-like growth factor-1(IGF-1)and fibroblast growth factor-2(FGF-2)were detected.Results The operative time in the study group was(125.46±12.85)minutes,which was shorter than that in the control group[(130.24±10.53)minutes],the intraoperative bleeding volume in the study group was(254.19±20.73)mL,which was less than that in the control group[(262.86±18.62)mL],the fracture healing time and hospital stay in the study group were(11.74±3.26)weeks and(14.23±1.76)days,which were shorter than those in the control group[(13.15±3.34)weeks and(15.08±2.11)days],the differences were statistically significant(P<0.05).The shoulder flexion and extension range of motion in the study group was(132.26±4.46)°,which was greater than that in the control group[(127.74±5.11)°],and the Mayo score in the study group was(85.46±2.34)points,which was higher than that in the control group[(80.78±3.23)points],the excellent and good rate of elbow function in the study group was 98.00%,which was higher than that in the control group(80.00%),the differences were statistically significant(P<0.05).After operation,the levels of serum IG

关 键 词：有限接触动力加压钢板内固定术 皮质外骨桥 肱骨骨折 骨不连 生活质量 

分 类 号：R687.3[医药卫生—骨科学]