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[带或不带应用内下螺钉的锁定钢板治疗肱骨近端骨折的临床疗效比较]

[Comparison of clinical effect on locking plate for proximal humeral fracture with or without application of inferomedial screws].

作者信息

Guo Xiu-wu, Fan Jian, Yuan Feng

出版信息

Zhongguo Gu Shang. 2016 Jun;29(6):509-12.

Abstract

OBJECTIVE

To compare clinical outcomes of locking plate for proximal humeral fracture whether application of inferomedial screws.

METHODS

From January 2012 to July 2013, 46 patients with proximal humeral fracture underwent locking plates were retrospectively analyzed. There were 25 males and 21 females aged from 29 to 80 years old with an average of 55.1 years old. Among them, 25 patients were treated with inferomedial screws (support group), including 13 males and 12 females aged from 38 to 80 years old with an average of (55.8 ± 11.8) years old; 8 cases were part two fracture,10 cases were part three fracture and 7 cases were part four fracture according to Neer classification. Twenty-one patients were treated without inferomedial screws (non-support group), including 12 males and 9 females aged from 29 to 79 years old with an average of (54.2 ± 14.8)years old; 6 cases were part two fracture, 9 cases were part three fracture and 6 cases were part four fracture according to Neer classification. Operative time, fracture healing time and complications were observed and compared, Neer scoring of shoulder joint were used to evaluate clinical effect.

RESULTS

All patients were followed up from 12 to 41 months with an average of 15.6 months. Operative time and fracture healing time in support group was (1.6 ± 0.4) h and (3.0 ± 0.6) months, and (1.5 ± 0.4) h and (3.1 ± 0.6) months in non-support group, while there was no statistical difference in operative time and fracture healing time between two groups. There was significant differences in Neer score between support group (89.7± 4.9) and non-support group (83.1 ± 7.1). No complication occurred in support group,while 4 cases occurred complications in non-support group.

CONCLUSION

Locking plate with inferomedial screws for proximal humeral fracture has advantages of stable fixation, less complications, quick recovery of function and satisfied clinical effect.

摘要

目的

比较应用内侧下螺钉的锁定钢板治疗肱骨近端骨折的临床疗效。

方法

回顾性分析2012年1月至2013年7月间46例接受锁定钢板治疗的肱骨近端骨折患者。其中男性25例,女性21例,年龄29至80岁,平均55.1岁。其中25例患者采用内侧下螺钉治疗(支持组),包括男性13例,女性12例,年龄38至80岁,平均(55.8±11.8)岁;根据Neer分型,8例为二部分骨折,10例为三部分骨折,7例为四部分骨折。21例患者未采用内侧下螺钉治疗(非支持组),包括男性12例,女性9例,年龄29至79岁,平均(54.2±14.8)岁;根据Neer分型,6例为二部分骨折,9例为三部分骨折,6例为四部分骨折。观察并比较手术时间、骨折愈合时间及并发症,采用肩关节Neer评分评估临床疗效。

结果

所有患者均获随访,随访时间12至41个月,平均15.6个月。支持组手术时间和骨折愈合时间分别为(1.6±0.4)小时和(3.0±0.6)个月,非支持组分别为(1.5±0.4)小时和(3.1±0.6)个月,两组手术时间和骨折愈合时间差异无统计学意义。支持组Neer评分(89.7±4.9)与非支持组(83.1±7.1)差异有统计学意义。支持组无并发症发生,非支持组有4例发生并发症。

结论

应用内侧下螺钉的锁定钢板治疗肱骨近端骨折具有固定稳定、并发症少、功能恢复快、临床疗效满意等优点。

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