经皮微创接骨板与切开复位内固定治疗肱骨近端NeerⅢ、Ⅳ部分骨折的疗效及并发症比较  

Comparison of the effect and complications of percutaneous minimally invasive plate internal fixation and open reduction and internal fixation in the treatment of partial Neer III-IV proximal humeral fracture

作　　者：陈铎允 孙秀钦[1] 秦晓彬[1] CHEN Duoyun;SUN Xiuqin;QIN Xiaobin(Department of Orthopedics 3rd ward,Nanyang Central Hospital,Nanyang,Henan,473000,China)

机构地区：[1]南阳市中心医院骨科三病区,河南南阳473000

出　　处：《实用手外科杂志》2024年第2期197-200,共4页Journal of Practical Hand Surgery

摘　　要：目的对比观察肱骨近端骨折经皮微创接骨板与切开复位内固定治疗的效果及并发症发生情况。方法2019年9月-2022年9月收治76例肱骨近端骨折患者,根据患者自愿选择术式分为微创组38例和复位组38例,分别采用经皮微创接骨板内固定治疗和切开复位内固定治疗,比较两组治疗效果和并发症发生情况。结果微创组手术切口长度、手术时间、术中出血量明显少于复位组(P<0.05),而两组骨折愈合时间、术后住院时间比较差异无统计学意义(P>0.05)。术后3个月内微创组与复位组并发症发生率差异无统计学意义(P>0.05)。术前,两组疼痛等级、日常生活活动(ADL)、关节活动度(ROM)、徒手肌力检查(MMT)对比差异无统计学意义(P>0.05),术后3个月两组疼痛等级、ADL、ROM、MMT评分均升高,微创组疼痛等级、ADL、ROM、MM评分显著高于复位组(P<0.05)。术后3个月,微创组肩关节功能Neer评分优良率为89.47%,明显高于复位组68.42%(P<0.05)。结论与切开复位内固定相比,经皮微创接骨板内固定治疗肱骨近端NeerⅢ、Ⅳ部分骨折具有手术创面小、时间快、出血量少等优点,对促进肩关节功能恢复更具优势。Objective To compare the effect and complications of percutaneous minimally invasive plate internal fixation and open reduction and internal fixation in the treatment of partial NeerⅢ-Ⅳproximal humeral fracture.Methods A total of 76 patients with proximal humeral fracture who underwent surgical treatment in the hospital from September 2019 to September 2022 were divided into minimally invasive group(38 patients treated with percutaneous minimally invasive plate internal fixation)and reduction group(38 patients treated with open reduction and internal fixation).The curative effect and complications were compared between two groups.Results The length of surgical incision,operation time and intraoperative blood loss of the minimally invasive group were significantly shorter/less than those of the reduction group(P<0.05).There was no significant difference in fracture healing time or postoperative hospital stay between the groups(P>0.05).There was no significant difference in the incidence of complications between the groups within 3 months after surgery(P>0.05).There was no statistically significant difference in the grade of pain,activities of daily living(ADL),range of motion(ROM)or manual muscle testing(MMT)between the groups before surgery(P>0.05).In the 3rd month after surgery,the grade of pain,ADL,ROM and MMT scores in two groups were increased.These indicators in the minimally invasive group were significantly higher than those in the reduction group(P<0.05).In the 3rd month after surgery,the excellent and good rate of Neer score of shoulder function in the minimally invasive group was significantly higher than that in reduction group(89.47%vs 68.42%,P<0.05).Conclusion Compared with open reduction and internal fixation,percutaneous minimally invasive plate internal fixation has the advantages of smaller surgical incision,shorter duration and less blood loss in the treatment of partial Neer III-IV proximal humeral fracture.In addition,the latter can promote shoulder function recovery.

关 键 词：肱骨骨折 骨折固定术 微创 临床疗效 并发症 

分 类 号：R687.3[医药卫生—骨科学]