Multiloc髓内钉和钢板固定治疗肱骨干骨折的疗效分析  

Therapeutic effect analysis of Multiloc intramedullary nail and steel plate fixation in the treatment of humeral shaft fractures

作　　者：郭建阔 李卫华 孟涛 GUOJ iankuo;LI Weihua;MENG Tao(Department of Orthopedics,Huaihe Hospital of Henan University,Kaifeng 475000,CHN)

机构地区：[1]河南大学淮河医院骨科,河南开封475000

出　　处：《河南大学学报（医学版）》2024年第3期205-209,共5页Journal of Henan University:Medical Science

基　　金：河南省重点研发与推广专项(232102310202);河南省医学科技攻关计划联合共建项目(2018020335)。

摘　　要：目的:探讨Multiloc髓内钉和钢板固定治疗肱骨干骨折的临床效果。方法:选取在某医院骨科接受治疗的肱骨干骨折患者60例,随机均分为钢板组(30例,采用锁定钢板内固定)和髓内钉组(30例,采用Multiloc髓内钉治疗)。比较两组手术指标、术后3及6个月肩关节活动度及术后1 a肩关节和肘关节功能,并统计并发症。结果:与钢板组比较,髓内钉组切口长度减小,术中出血量减少,手术时间缩短(P<0.05)。与术前比较,术后3个月和6个月两组患者肩关节前屈上举及外展上举活动度均明显大于术前,且髓内钉组均大于钢板组(P<0.05)。术后1 a两组患者Neer肩关节功能和Mayo肘关节功能评分均明显高于术前(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。髓内钉组总并发症发生率低于钢板组(6.67%vs 26.67%,P<0.05)。结论:锁定钢板内固定和Multiloc髓内钉均可有效治疗肱骨干骨折,促进骨折端复位,改善患者肩关节和肘关节功能,但Multiloc髓内钉可有效缩短手术时间,降低术中出血量和术后并发症发生风险,促进术后肩关节活动度的改善。Objective:To investigate the therapeutic effect of Multiloc intramedullary nail and steel plate fixation in the treatment of humeral shaft fractures.Methods:60 patients of humeral shaft fractures who were treated in department of orthopedics were divided into steel plate group(30 cases,treated with internal fixation with locking plate)and intramedullary nail group(30 cases,treated with Multiloc intramedullary nail).The operation indexes,shoulder joint range of motion 3 and 6 months after operation and shoulder joint and elbow joint function 1 year after operation were compared between the two groups,and the complications were recorded.Results:Compared with the steel plate group,the length of incision in the intramedullary nail group reduced,the amount of intraoperative bleeding reduced,the time of operation shortened(P<0.05).Compared with preoperative,the range of motion of shoulder joint flexion and abduction and lifting at 3 and 6 months after operation was significantly greater than those before operation in the two groups,and the intramedullary nail group was greater than that in the steel plate group(P<0.05).The scores of Neer shoulder joint function and Mayo elbow joint function 1 year after operation in both groups were significantly higher than those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The total complication rate in the intramedullary nail group was lower than that in the steel plate group(6.67%vs 26.67%,P<0.05).Conclusion:Both internal fixation with locking plate and Multiloc intramedullary nail can effectively treat the comminuted fracture of humeral shaft,promote the reduction of the fracture end,improve the shoulder joint and elbow joint function.However,Multiloc humeral intramedullary nail can effectively shorten the operation time,reduce the intraoperative bleeding volume and the risk of postoperative complications,promote the improvement of shoulder joint range of motion after operation.

关 键 词：肱骨干骨折 髓内钉 锁定钢板内固定 肩关节活动度 

分 类 号：R683.41[医药卫生—骨科学]