肱骨Multiloc髓内钉固定与锁定钢板固定治疗肱骨外科颈骨折的效果比较  

Comparison of the Effect of Humeral Multiloc Intramedullary Nail Fixation and Locking Plate Fixation in the Treatment of Humeral Surgical Neck Fractures

作　　者：赵晓龙 梁超[1] 史鹏飞[1] 毕永耀 王银辉 万家晗 杨冬松 ZHAO Xiaolong;LIANG Chao;SHI Pengfei;BI Yongyao;WANG Yinhui;WAN Jiahan;YANG Dongsong(Department of Emergency Surgery,Luohe Central Hospital,Luohe 462000,China;Department of Trauma Orthopedics,Luohe Fifth People's Hospital,Luohe 462000,China)

机构地区：[1]漯河市中心医院急诊外科,河南漯河462000 [2]漯河市第五人民医院创伤骨科,河南漯河462000

出　　处：《临床医学工程》2025年第4期361-365,共5页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20200885)。

摘　　要：目的对比分析肱骨Multiloc髓内钉固定与锁定钢板固定治疗肱骨外科颈骨折的临床效果。方法选取2023年6月至2024年6月漯河市中心医院收治的肱骨外科颈骨折患者84例,根据治疗方式不同分为髓内钉组(42例,采用肱骨Multiloc髓内钉固定治疗)和钢板组(42例,采用锁定钢板固定治疗)。比较两组的围术期相关指标、复位质量、患肢疼痛程度、肩关节功能评分、肩关节活动度及并发症。结果髓内钉组术中出血量少于钢板组,切口长度短于钢板组,有明显统计学差异(P<0.05)。两组术后颈干角均大于术前,Constant-Murley评分均高于术前,视觉模拟评分法(VAS)评分均低于术前,肩关节前屈、外展、外旋与内旋活动度均大于术前,且髓内钉组术后颈干角大于钢板组,有明显统计学差异(P<0.05);两组手术时间、术后VAS评分、Constant-Murley评分、肩关节前屈、外展、外旋与内旋活动度及并发症总发生率比较,无明显统计学差异(P>0.05)。结论肱骨Multiloc髓内钉固定与锁定钢板固定治疗肱骨外科颈骨折安全性相当,且均可取得良好的长期治疗效果,患者术后患肢疼痛程度减轻,肩关节功能与活动度恢复良好;但相较于锁定钢板固定,肱骨Multiloc髓内钉固定切口小,患者术中出血量少,且术后早期颈干角恢复更好。Objective To compare and analyze the clinical effect of humeral Multiloc intramedullary nail fixation and locking plate fixation in the treatment of humeral surgical neck fractures.Methods A total of 84 patients with humeral surgical neck fracture admitted to Luohe Central Hospital from June 2023 to June 2024 were selected and divided into the intramedullary nail group(42 cases,treated with humeral Multiloc intramedullary nail fixation)and the plate group(42 cases,treated with locking plate fixation)according to different treatment methods.The perioperative related indexes,reduction quality,limb pain degree,shoulder joint function score,shoulder joint mobility and complications were compared between the two groups.Results The intraoperative bleeding volume of the intramedullary nail group was less than that of the plate group,and the incision length was shorter than that of the plate group,with significant statistical difference(P<0.05).The postoperative neck-shaft angles of the two groups were greater than those before the operation,the Constant-Murley scores were higher than those before the operation,the visual analogue scale(VAS)scores were lower than those before the operation,and the flexion,abduction,external rotation and internal rotation activity of the shoulder joint were greater than those before the operation,and the neck-shaft angle of the intramedullary nail group after the operation was greater than that of the plate group,with significant statistical difference(P<0.05).There was no significant difference in operation time,postoperative VAS score,Constant-Murley score,flexion,abduction,external rotation and internal rotation activity of the shoulder joint and total incidence of complications between the two groups(P>0.05).Conclusions Humeral Multiloc intramedullary nail fixation and locking plate fixation for the treatment of humeral surgical neck fractures have comparable safety,and both can achieve good long-term therapeutic effect,and the patient's postoperative pain of the affected limb is redu

关 键 词：肱骨外科颈骨折 肱骨Multiloc髓内钉固定 锁定钢板固定 关节功能 复位质量 

分 类 号：R687.3[医药卫生—骨科学]