经前侧入路前置锁定桥接钢板治疗肱骨中下段骨折的安全性和近期临床疗效观察  

Observation on safety and short-term clinical efficacy of preposition locking bridged plates via anterior lateral approach in treating middle and lower humeral fracture

作　　者：王广 廖维 张有强 陈小恒 鄢陵 WANG Guang;LIAO Wei;ZHANG Youqiang;CHEN Xiaoheng;YAN Ling(Department of Orthopedics,Third Affiliated Hospital of Zunyi Medical University/Zunyi Municipal First People’s Hospital,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义医科大学第三附属医院/遵义市第一人民医院骨科,贵州遵义563000

出　　处：《重庆医学》2023年第22期3443-3447,共5页Chongqing medicine

基　　金：贵州省自然科学基金项目(黔科合基础[2019]1325)。

摘　　要：目的探讨经前侧入路前置锁定桥接钢板治疗肱骨中下段骨折的安全性和近期临床疗效。方法回顾性分析2018年6月至2021年6月该院采用前侧入路前置锁定桥接钢板治疗闭合性肱骨中下段骨折27例患者的临床资料。结果27例患者均顺利完成手术,术后随访时长12~20个月,平均(13.7±2.2)个月。术中及术后均未发生桡神经急、慢性损伤,切口均Ⅰ级甲等愈合。平均手术时长为(87.4±18.3)min,术中平均出血量为(136.5±29.5)mL,平均住院时长为(12.4±2.3)d。骨折均获骨性愈合,愈合时间(4.2±0.4)月。术后1、3、12个月视觉疼痛模拟评分(VAS)均低于术前(P<0.05),肘关节Mayo评分(MEPS)及肩关节Constant-Murley功能评分(CMS)均明显高于术前(P<0.05)。随访过程中所有患者均未发生桡神经损伤、骨髓炎及骨折延迟愈合、不愈合、畸形愈合等并发症。结论经前侧入路锁定桥接钢板前置治疗肱骨中下段骨折可有效避免医源性桡神经损伤,术中、术后并发症发生率低,近期疗效满意。Objective To investigate the safety and short-term clinical efficacy of prepositional locking bridged plates via anterior lateral approach in the treatment of middle and lower humeral fractures.Methods The clinical data of 27 patients with middle and lower humeral fractures treated by preposition locking bridged plates via anterior lateral approach in this hospital from June 2018 to June 2021 were retrospectively analyzed.Results Twenty-seven patients all successfully completed the operation and the postoperative follow up lasted for 12-20 months,averaged(13.7±2.2)months.No acute or chronic radial nerve injury and chronic injury occurred intraoperatively or postoperatively,and all incisions were the gradeⅠand grade A healing.The mean operation time was(87.4±18.3)min,the mean intraoperative blood loss amount was(136.5±29.5)mL and the mean hospital stay was(12.4±2.3)d.The fracture obtained the bony union with the healing time of(4.2±0.4)months.The visual analogue scale(VAS)score in postoperative 1,3,12 months was lower than that before operation(P<0.05),the Mayo elbow performance score and the C onstant-Murley functional score were significantly higher than those before operation(P<0.05).No complications such as radial nerve injury,osteomyelitis,delayed fracture healing,nonunion and malunion occurred in all patients during the follow-up period.Conclusion The prepositional locking bridged plates via anterior approach in the treatment of middle and lower humeral fractures could effectively avoids the iatrogenic radial nerve injury with low intraoperative and postoperative complication occurrence rate and the short term efficacy is satisfactory.

关 键 词：肱骨中下段骨折 前侧入路 锁定桥接钢板前置 医源性桡神经损伤 

分 类 号：R683.41[医药卫生—骨科学]