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[肱骨近端粉碎性骨折切开复位内固定治疗的研究]

[Study of the treatment of comminuted fractures of proximal humerus with open reduction and internal fixation].

作者信息

Zhang Zuo-Jun, Niu Su-Ling, Chang Zhong-Xiao, Ning Fan-You

机构信息

Henan Luoyang Orthopedic-Traumatological Hospital, Luoyang 471002, Henan, China.

出版信息

Zhongguo Gu Shang. 2009 Nov;22(11):824-6.

Abstract

OBJECTIVE

To study the effect of the treatment for comminuted fractures of proximal humerus with open reduction and internal fixation, and the influence of the different internal fixation.

METHODS

From January 2003 to June 2007, 423 cases of comminuted fractures of proximal humerus were treated with open reduction and internal fixation. Among them, 139 patients included 51 males and 88 females were treated with the Kirschner needle with an average age of 55.8 years old ranging from 35 to 72 years, and the average course was 7 days (from 3 to 20 days); 103 patients included 48 males and 55 females were treated with the cloverleaf plate with an average age of 56.7 years old (from 22 to 76 years), and the average course was 8.5 days (from 3 to 23 days); 181 patients included 85 males and 96 females were treated with the locking plate with an average age of 57.1 years old (from 29 to 77 years), and the average course was 7.9 days (from 3 to 21 days). The pain, daily activities, orbit, and the strength of the shoulder were evaluated with the Constant's scale.

RESULTS

The wound of all the cases was primary healing. All patients were followed-up for over 12 months, the sings and symptoms of all the patients were improved very well. There was significant difference between, before and after operation on Constant's scoring. While there was not significant difference among the different internal fixation.

CONCLUSION

Open reduction and internal fixation is effective for comminuted fractures of proximal humerus. There is no significant difference on therapeutic efficacy in different internal fixation.

摘要

目的

探讨切开复位内固定治疗肱骨近端粉碎性骨折的疗效及不同内固定方式的影响。

方法

2003年1月至2007年6月,对423例肱骨近端粉碎性骨折患者行切开复位内固定治疗。其中,139例患者(男51例,女88例)采用克氏针治疗,平均年龄55.8岁(35~72岁),平均病程7天(3~20天);103例患者(男48例,女55例)采用三叶形钢板治疗,平均年龄56.7岁(22~76岁),平均病程8.5天(3~23天);181例患者(男85例,女96例)采用锁定钢板治疗,平均年龄57.1岁(29~77岁),平均病程7.9天(3~21天)。采用Constant评分法评估疼痛、日常活动、肩关节活动范围及肩部力量。

结果

所有病例伤口均一期愈合。所有患者均获随访12个月以上,症状体征均明显改善。Constant评分术前、术后比较差异有统计学意义。不同内固定方式之间比较差异无统计学意义。

结论

切开复位内固定治疗肱骨近端粉碎性骨折疗效确切。不同内固定方式的治疗效果差异无统计学意义。

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