[1]陈苑妮△ 黎清斌 张兆华 劳永锵.手法复位小夹板外固定治疗老年NeerⅢ型肱骨近端骨折36例[J].中国中医骨伤科杂志,2017,25(06):19-22.
　CHEN Yuanni LI Qingbin ZHANG Zhaohua LAO Yongqiang.36 Cases of Manual Reduction with Small-splint External Fixation Treating for Proximal Humerus Fractures of Neer Ⅲ Type in Elderly[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(06):19-22.
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手法复位小夹板外固定治疗老年NeerⅢ型肱骨近端骨折36例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年06期
页码:
19-22
栏目:
临床研究
出版日期:
2017-07-08

文章信息/Info

Title:
36 Cases of Manual Reduction with Small-splint External Fixation Treating for Proximal Humerus Fractures of Neer Ⅲ Type in Elderly
文章编号:
1005-0205(2017)06-0019-04
作者:
陈苑妮1△ 黎清斌1; 2 张兆华1 劳永锵1
1.广东佛山市中医院(广东 佛山,528000)
2.广州中医药大学
△.通信作者 E-mail:2453821632@qq.com
Author(s):
CHEN Yuanni1△ LI Qingbin1; 2 ZHANG Zhaohua1 LAO Yongqiang1
1.Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, Guangdong China;
2.Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, China.
关键词:
肱骨近端骨折;  NeerⅢ型;  手法复位;  小夹板外固定;  老年
Keywords:
proximal humerus fractures;  Neer Ⅲ;  manual reduction;  small-splint external fixation;  elder
分类号:
R683.41
文献标志码:
A
摘要:
目的:探讨手法复位小夹板外固定治疗老年NeerⅢ型肱骨近端骨折的临床疗效。方法:将符合纳入标准的78例老年NeerⅢ型肱骨近端骨折患者按治疗方式分为保守组(36例)和手术组(42例),保守组采用手法复位小夹板外固定治疗,手术组采用切开复位锁定钢板内固定治疗,分别观察和比较两组患者影像学骨折复位情况、并发症、肩关节功能以及临床疗效。结果:保守组患者影像学骨折复位优良率为52.78%,而手术组优良率为90.48%,差异有统计学意义(P=0.000 1); 保守组并发症总发生率(11.11%)明显低于手术组(30.95%),差异有统计学意义(μ=3.952 0,P=0.000 1); 在术后第6周及第3个月随访,手术组患者Constant-Murley肩关节功能评分结果均优于保守组,差异有统计学意义(P<0.05); 随着随访时间延长,两组患者Constant-Murley肩关节功能评分差异逐渐变小,在术后第6个月、1年时,差异无统计学意义(P>0.05); 保守组临床疗效优良率为75.00%,手术组优良率为83.33%,差异无统计学意义(μ=1.005 2,P=0.314 8)。结论:两种治疗方式治疗老年NeerⅢ型肱骨近端骨折均可获得满意的临床疗效和肩关节功能恢复,但切开复位锁定钢板内固定治疗可获得更好的骨折复位,而手法复位小夹板外固定治疗并发症更少。
Abstract:
Objective: To investigate the clinical efficacy of manual reduction with small-splint external fixation treating for the proximal humerus fracture of Neer Ⅲ type in elderly. Methods: All 78 elderly patients with proximal humerus fracture of Neer Ⅲ type, who met the inclusion criteria, were divided into the conservative group(n=36)and the operation group(n=42)according to the standard of treatment. The conservative group was treated by external fixation with small-splint external fixation, and the surgical treatment group was treated by open reduction with anatomic plate internal fixation. The image fracture reduction, the complications, the shoulder function and the clinical efficacy were observed and compared between the two groups. Results: The excellent and good rate of radiographic fracture reduction was 52.78% in the conservative group and 90.48% in the operation group. There was significant difference between the two group(P=0.000 1). The overall complication rate in the conservative group(11.11%)was significantly lower than that in the surgery group(30.95%)(μ=3.952 0, P=0.000 1). The Constant-Murley shoulder function score in surgery group was better than that of conservative group at the follow-up time points of 6 weeks and 3 months after surgery(P<0.05). With the extension of follow-up time, the difference of the Constant-Murley shoulder function score between the two groups gradually became smaller, and there was no significant difference at 6 months and 1 year after operation(P>0.05). The excellent rate of the curative effect was 75.00% in the conservative group and 83.33% in the operative group. There was no significant difference between the two groups(μ=1.005 2,P=0.314 8). Conclusion: The two kinds of treatment for the proximal humerus fracture of Neer Ⅲ type in elderly can get satisfactory clinical efficacy and shoulder function recovery. The open reduction with anatomic plate internal fixation can get a better fracture reduction, but the external fixation with small-splint can get fewer complications.

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更新日期/Last Update: 2017-06-15