[1]段来宝,毕宏政,赵磊△.手法整复髓内钉内固定治疗肱骨近端骨折的临床对照研究[J].中国中医骨伤科杂志,2023,31(07):27-33.[doi:10.20085/j.cnki.issn1005-0205.230706 ]
　DUAN Laibao,BI Hongzheng,ZHAO Lei.Controlled Clinical Study of Manual Reduction and Intramedullary Nail Fixation in Treating Proximal Humerus Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(07):27-33.[doi:10.20085/j.cnki.issn1005-0205.230706 ]
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手法整复髓内钉内固定治疗肱骨近端骨折的临床对照研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年07期
页码:
27-33
栏目:
临床研究
出版日期:
2023-07-15

文章信息/Info

Title:
Controlled Clinical Study of Manual Reduction and Intramedullary Nail Fixation in Treating Proximal Humerus Fracture
文章编号:
1005-0205(2023)07-0027-07
作者:
段来宝1; 毕宏政1; 赵磊1△
1山东省文登整骨医院(山东 威海,264400)
Author(s):
DUAN Laibao1; BI Hongzheng1; ZHAO Lei1△
1Shandong Wendeng Osteopath Hospital,Weihai 264400,Shandong China.
关键词:
手法整复;  髓内固定;  弹性髓内钉;  微创治疗;  肱骨近端骨折
Keywords:
manual reduction;  intramedullary fixation;  elastic intramedullary nail;  minimally invasive treatment;  fracture of the proximal humerus
分类号:
R683.41
DOI:
10.20085/j.cnki.issn1005-0205.230706
文献标志码:
A
摘要:
目的:通过对手法整复经皮微创弹性髓内钉内固定与切开复位锁定钢板内固定治疗肱骨近端骨折的回顾性分析,评价其临床疗效。方法:选取本院2019年7月至2021年8月治疗的63例肱骨近端骨折患者,按照Neer分型为Ⅱ型骨折28例,Ⅲ型骨折35例。按照治疗方式分为两组,其中32例行手法整复经皮微创弹性髓内钉内固定治疗(观察组); 31例行切开复位锁定钢板内固定治疗(对照组)。分别记录两种治疗方式的手术切口长度、术中出血量、手术操作时间; 应用VAS 评分记录术后1、3天手术伤口疼痛情况; 比较两组骨折愈合时间; 随访记录采用Constant-Murley评分对肩关节功能进行评定并进行比较。结果:63例均获得随访,随访时间4～18个月,平均11.4个月。两组患者均未出现切口感染、复位丢失、骨折不愈合及肱骨头坏死(1例除外)的情况。观察组在手术切口长度、术中出血量、手术时间、骨折愈合时间及术后第1天和第3天疼痛VAS评分方面明显优于对照组,差异有统计学意义(P<0.05); 观察组肩关节Constant-Murley功能评分与对照组差异无统计学意义(P>0.05)。结论:手法整复经皮微创弹性髓内钉内固定治疗肱骨近端骨折,既能最大程度的保护骨折端血运,又能牢固固定,可早期行肩关节功能锻炼,促使肩关节功能迅速恢复,具有创伤小、术中出血少、固定可靠等优点,是一种治疗肱骨近端骨折的优良方法,值得临床推广应用。
Abstract:
Objective:To evaluate the clinical efficacy of manual reduction and minimally invasive percutaneous elastic intramedullary nail internal fixation and open reduction and locking plate internal fixation in treating proximal humerus fracture through retrospective analysis.Methods:63 patients with proximal humerus fracture treated from July 2019 to August 2021 were selected.28 cases were type Ⅱ fracture and 35 cases were type Ⅲ fracture according to Neer classification.They were divided into two groups according to the treatment methods.Among them,32 underwent manual reduction and percutaneous minimally invasive elastic intramedullary nail and internal fixation,and were set as the observation group.31 patients were treated with open reduction and locked plate internal fixation and were set as control group.Incision length,intraoperative blood loss and operation time of the two treatment groups were recorded respectively.VAS score was used to record postoperative wound pain on the 1st and 3rd postoperative day.The fracture healing time of the two groups was compared.Constant-Murley score was used to evaluate and compare shoulder joint function in follow-up records.Results:All 63 cases were followed up for 4 to 18 months with on average age of 11.4 months.There was no knife infection,loss of reduction,nonunion of fracture and necrosis of humeral head in the two groups.The observation group was significantly better than the control group in terms of incision length,intraoperative blood loss,operation time,fracture healing time and postoperative pain VAS score at the first and third day,with statistical significance(P<0.05).There was no significant difference in Constant-Murley function score between the observation group and the control group(P>0.05).Conclusion:Manual reduction and percutaneous minimally invasive elastic intramedullary nail fixation on the treatment of proximal humeral fractures can protect the blood supply at the fracture end to the greatest extent,firmly fix it,exercise the shoulder joint function at an early stage,and promote shoulder joint function recovery quickly,It has the advantages of small trauma,less intraoperative bleeding,reliable fixed,which is an excellent method in treating of proximal humeral fractures,and is worthy of clinical popularization and application.

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备注/Memo

备注/Memo:
△通信作者 E-mail:zhaolei1106@163.com
更新日期/Last Update: 2023-07-10