中医正骨手法结合锁定钢板微创治疗老年肱骨近端Neer2、3部分骨折的疗效观察  

Curative effect of traditional Chinese medicine bone-setting manipulation combined with locking plate minimally invasive treatment of neer2and 3fractures of proximal humerus in the elderly

作　　者：蒋柒 唐承杰[1] 贾军锋 潘汝南 李峰 潘青 JIANG Qi;TANG Chengjie;JIA Junfeng(Sichuan Provincial Orthopaedics Hospital,Chengdu Sichuan 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《四川中医》2024年第12期119-121,共3页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省医学会科研课题计划(编号:S22087)。

摘　　要：目的:探讨中医正骨手法闭合复位结合锁定钢板经皮微创治疗老年肱骨近端Neer2、3部分骨折的疗效。方法:选取我院2022年8月~2023年6月收治并随访的60例老年肱骨近端Neer2、3部分骨折患者,按随机数表法分为两组,观察组采用正骨手法结合锁定钢板经皮微创手术(经三角肌前外侧小切口入路)治疗,对照组行传统切开复位内固定术(经三角肌-胸大肌入路)治疗,各30例,年龄:70-93(82.3±5.75)岁,男13例,女47例。经过12~20个月随访,平均16.03个月。对两组患者的临床资料、术后并发症及肩关节功能评分展开对比分析,按照Constant-Murley评分系统评定肩关节功能。结果:两组患者均获得随访。两组患者术中透视次数比较,差异无统计学意义(P>0.05);但手术切口长度、术中出血量、手术时间、术后住院时间、骨折愈合时间、术后并发症、术后第1、7天视觉模拟评分(VAS)及术后1、3个月肩关节Constant-Murley功能评分比较,差异有统计学意义(P<0.05),即观察组手术切口小,术中出血量少,疼痛缓解快,手术时间及术后住院时间短,术后并发症少,肩关节功能好。结论:中医正骨手法结合经皮锁定钢板微创治疗老年肱骨近端Neer2、3部分骨折,具有手术切口小,出血量少,术后并发症少,手术时间及术后住院时间短,可早期康复锻炼等优势,值得临床推广。Objective:To explore the curative effect of traditional Chinese medicine closed reduction combined with locking plate percutaneous minimally invasive treatment of Neer2and 3fractures of proximal humerus in the elderly.Methods:From August 2022to June 2023,60elderly patients with Neer2and 3partial fractures of proximal humerus were selected for follow-up.Divided into two groups according to random number table method.The observation group was treated by bone-setting manipulation combined with locking plate percutaneous minimally invasive surgery(through the anterolateral deltoid small incision approach).The control group was treated with traditional open reduction and internal fixation(via deltoid-pectoralis major approach).There were 30cases in each group,aged from 70to 93(82.3±5.75)years,including 13males and 47females.After 12to 20months of follow-up,the average was 16.03months.The clinical data,postoperative complications and shoulder joint function scores of the two groups were compared and analyzed,and the shoulder joint function was evaluated according to the Constant-Murley scoring system.Results:Patients in both groups were followed up.There was no significant difference in the number of fluoroscopy between the two groups(P>0.05).However,there were significant differences in incision length,intraoperative blood loss,operation time,postoperative hospital stay,fracture healing time,postoperative complications,visual analogue scale(VAS)on the 1st and 7th day after operation and Constant-Murley function score of shoulder joint at the 1st and 3rd month after operation(P<0.05).That is,the observation group has small incision,less intraoperative bleeding,quick pain relief,short operation time and postoperative hospitalization,less postoperative complications and good shoulder function.Conclusion:Traditional Chinese medicine bone-setting manipulation combined with percutaneous locking plate minimally invasive treatment of Neer2and 3fractures of proximal humerus in the elderly has the advantages of small surgical

关 键 词：老年肱骨近端骨折 正骨手法 锁定钢板 微创手术 

分 类 号：R683.41[医药卫生—骨科学]