闭合复位经皮内固定治疗老年肱骨外科颈二或三部分骨折的疗效  

Efficacy of closed reduction and percutaneous internal fixation in the treatment of second or third part fracture of surgical neck of humerus in elderly patients

作　　者：兰天才 魏君如 杨寒石 俞淮曦 胡小吾 LAN Tiancai;WEI Junru;YANG Hanshi;YU Huaixi;HU Xiaowu(Department of Orthopedics,Langao County Hospital,Ankang,shaanxi,725400,China;Department of Orthopedics,Huai'an Second People's Hospital/the Affiliated Huai'an Hospital of Xuzhou Medical University,Huai'an,Jiangsu,223002,China)

机构地区：[1]岚皋县医院骨科,陕西安康725400 [2]淮安市第二人民医院/徐州医科大学附属淮安医院骨科,江苏淮安223002

出　　处：《当代医学》2023年第31期38-41,共4页Contemporary Medicine

摘　　要：目的探讨闭合复位经皮固定治疗老年肱骨外科颈二或三部分骨折的疗效。方法选取2017年1月至2021年12月淮安市第二人民医院收治的64例老年肱骨外科颈Neer二或三部分骨折患者作为研究对象,随机分为对照组与研究组,每组32例。对照组予以传统的胸大肌三角肌间隙入路切开复位内固定,观察组予以闭合复位经皮内固定。比较两组围手术期指标、肩关节功能、疼痛程度及术后并发症发生情况。结果观察组手术时间长于对照组,术中失血量、术后24 h引流量均明显少于对照组,骨折愈合时间明显短于对照组,差异有统计学意义(P<0.05)。术后1、3、6个月,两组Constant-Murley评分均高于前一时间点,且观察组高于对照组,差异有统计学意义(P<0.05)。术后1、3、6个月,两组视觉模拟评分法(VAS)评分均低于前一时间点,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,但差异无明显统计学意义。结论闭合复位经皮内固定治疗老年性肱骨外科颈二或三部分骨折效果显著,能明显缓解患者疼痛,提高早期肩关节功能恢复,并发症少,值得临床推广应用。Objective To investigate the efficacy of closed reduction and percutaneous internal fixation in the treatment of second or third part fracture of surgical neck of humerus in elderly patients.Methods 64 elderly patients with surgical neck fracture of humerus of Huai'an Second Peo-ple's Hospital from January of 2017 to December of 2021 were selected as the research subjects,they were randomly divided into the two groups,with 32 cases in each group.The control group was treated with traditional open reduction and internal fixation via the pectoralismajor and deltoid gap approach,while the observation group was treated with closed reduction and percutaneous internal fixation.The surgical related indexes,joint function,pain index and postoperative complications were compared between the two groups.Results The operation time in the observation group was longer than that in the control group,the intraoperative blood loss and postoperative 24 h drainage volume were significantly less than those in the control group,and the fracture healing time was significantly shorter than that in the control group,the differences were statistically significant(P<0.05).At 1,3 and 6 months after operation,the Constant-Murley scores of the two groups were higher than the previous time point,and the ob-servation group was higher than the control group,the differences were statistically significant(P<0.05).At 1,3 and 6 months after operation,the VAS scores of the two groups were lower than the previous time point,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).The complication rate in the observation group was lower than that in the control group,but the difference was not statistically significant.Conclusion Closed reduction and percutaneous internal fixation for the treatment of second or third part fracture of surgical neck of humerus in the elderly can obviously relieve pain and improve the early recovery of shoulder function,and less complications,which is worthy of cli

关 键 词：肱骨外科颈骨折 闭合复位 经皮内固定 

分 类 号：R687.3[医药卫生—骨科学]