间接复位技术联合philos自锁钢板内固定治疗Neer二部分肱骨近端骨折的疗效  

Effect of indirect reduction technique combined with philos self-locking plate internal fixation in the treatment of Neer two-part proximal humerus fracture

作　　者：殷子敬 林柳陆 彭建 区钰强 张云航 YIN Zi-jing;LIN Liu-lu;PENG Jian;QU Yu-qiang;ZHANG Yun-hang(Department of Orthopedics,Zhaoqing Hospital of Traditional Chinese Medicine,Zhaoqing 526020,Guangdong,China)

机构地区：[1]肇庆市中医院骨科,广东肇庆526020

出　　处：《川北医学院学报》2024年第12期1688-1691,1712,共5页Journal of North Sichuan Medical College

基　　金：广东省肇庆市科技创新指导类项目(2022040308009)。

摘　　要：目的:探讨间接复位技术联合肱骨近端解剖锁定钢板(philos)自锁钢板内固定治疗Neer二部分肱骨近端骨折的疗效。方法:选取80例Neer二部分肱骨近端骨折患者为研究对象,按照不同治疗方案分为对照组和实验组,每组各40例。实施传统切开内固定治疗为对照组;实施间接复位术+philos自锁钢板内固定治疗为观察组。比较两组患者手术情况和术前及术后各时间点疼痛情况;比较两组患者术前及术后1年肩关节Neer功能评分及肩关节Constant-Murley评分(CMS);记录两组患者治疗及随访期间并发症发生情况。结果:观察组患者术中出血量和手术时间少于对照组(P<0.05),术后住院时间和骨折愈合时间短于对照组(P<0.05)。术后1 d、1个月及6个月,两组患者VAS评分均随着时间推移下降(P<0.05),且观察组各时间点均低于对照组(P<0.05)。观察组患者Neer评分分级优于对照组(P<0.05);观察组Neer评分优良率87.50%高于对照组的67.50%(P<0.05)。术后1年,观察组患者CMS总分及日常活动、肩关节活动范围、患肢力量维度评分均高于对照组(P<0.05)。观察组患者并发症总发生率(5.00%)低于对照组(20.00%)(P<0.05)。结论:对Neer二部分肱骨近端骨折患者实施间接复位技术联合philos自锁钢板内固定治疗可促进患者术后恢复,减少并发症发生,缩短患者骨折愈合时间,减少术中出血量,有效缓解患者术后疼痛,促进患者肩关节功能恢复。Objective:To investigate the effect of indirect reduction technique combined with proximal humeral anatomical locking plate(philos)self-locking plate internal fixation in the treatment of Neer two-part proximal humeral fractures.Methods:80 patients with Neer two-part proximal humeral fractures were selected and divided into two groups according to different treatment methods,40 cases in each group.The control group was treated with traditional incision and internal fixation,and the observation group was treated with indirect reduction and philos self-locking plate internal fixation.The general condition of the operation and the pain[visual analogue pain score(VAS)]before operation,1 day after operation,1 month after operation,6 months after operation and 1 year after operation were compared between the two groups.The Neer function score and Constant-Murley score(CMS)of shoulder joint were compared between the two groups before and 1 year after operation.The complications of the two groups during treatment and follow-up were recorded.Results:The intraoperative blood loss and surgical time of the observation group were less than those of the control group(P<0.05),and the postoperative hospitalization time and fracture healing time were shorter than those of the control group(P<0.05).After operation 1 day,1 month and 6 months,the VAS scores of the two groups decreased with the passage of time(P<0.05),and the VAS scores of the observation group were lower than those of the control group(P<0.05).Compared with the control group,the Neer score grading of the observation group was better(P<0.05).Compared with 67.50%of the control group,the excellent and good rate of the observation group was higher(87.50%,P<0.05).1 year after operation,compared with the control group,the total score of CMS and the scores of daily activities,shoulder joint range of motion and limb strength dimension in the observation group were higher(P<0.05).Compared with the control group,the the observation group s total complications incidence was lo

关 键 词：Neer二部分肱骨近端骨折 间接复位技术 肱骨近端解剖锁定钢板 术后恢复 肩关节功能 并发症 

分 类 号：R274.11[医药卫生—中医骨伤科学]