摘要
目的：探讨锁定加压钢板（LCP）、带锁髓内钉和多枚克式针应用在中老年肱骨外科颈复杂性骨折治疗中的临床疗效。方法：回顾本院2002年10月~2007年3月手术治疗并获得1年随访的肱骨外科颈骨折58例,年龄39~65岁,NeerⅡ型骨折33例,Ⅲ~Ⅳ型骨折25例,按手术方式不同分为：LCP组36例,带锁髓内钉治疗组（A组）11例,多枚克氏针治疗组（B组）11例,各组均采用手法复位。术后就术中出血量、切口总长度、伤口延迟愈合率、8周骨折愈合率、术后肩关节外展活动度方面,将LCP组分别与A组、B组进行统计学分析,肩关节功能按Constant-Murley绝对值标准评分。结果：：LCP组和A组比较切口总长度、伤口延迟愈合率、8周骨折愈合率差异无统计学意义（P〉0.05）,两组术中出血量、肩关节最大外展度数比较差异有统计学意义（P〈0.05）。LCP组和B组比较术中出血量、伤口延迟愈合率差异无统计学意义（P〉0.05）,两组切口总长度、8周骨折愈合率、肩关节最大外展度数差异有统计学意义（P〈0.05）。肩关节功能Constant-Murley绝对值评分结果：治疗Ⅱ型骨折LCP组优良率90.9%,Ⅲ~Ⅳ型骨折LCP组优良率85.7%。A组优良率45.5%,B组优良率36.4%。结论：治疗中老年肱骨外科颈复杂性骨折首选应用锁定加压钢板技术固定,其疗效优于带锁髓内钉和多枚克氏针固定技术。
Objective：To investigate the clinical efficacy of locking compression plate （LCP）, interlocking intramedullary nail and multi-Kirschner wire in treating complicated surgical neck fractures of the humerus in middle and aged patients. Meth- ods：From October 2002 to March 2007, 58 patients of surgical neck fractures of the humerus, aging from 39 to 65 years, were hospitalized in our hospital, who were followed up for more than 1 year. Among all the patients, 33 cases were type- Ⅱ fracture and 25 cases were type- Ⅲ-Ⅳ fractures based on Neer classification. Thirty-six cases were treated with LCP （group LCP）, 11 cases were treated with interlocking intramedullary nail （group A） and 11 cases were treated with multi- Kirschner wire （group B）. All patients received manipulative reduction. After operation, intraoperative blood loss, incision length, delayed union rate, fracture union rate of 8 weeks and abduction movements of shoulder joint were observed. Constant-murley System was used to detect shoulder function. Results：No significant differences were found in incision length, delayed union rate or fracture union rate of 8 weeks between group LCP and group A （P〉0.05）, but there were marked differences in intraoperative blood loss and abduction range of shoulder joint between the two groups （P〈0.05）. As for group LCP and group B, no significant differences in blood loss or delayed union rate were found （P〉0.05）, but statistical differences in incision length, fracture union rate of 8 weeks and abduction range of shoulder joint were observed （P〈0.05）. According to the Constant-Murley rating system, the excellent and good rate of therapy effect for type-Ⅱ fracture and type-Ⅲ,Ⅳ fractures in group LCP was 90.9% or 85.7%, respectively. While in group A and group B, the excellent and good rate was 45.5% and 36.4%, respectively. Conclusion： LCP should be the first choice in middle and aged patients in time of surgical fracture of the humerus due to its more favorable e
出处
《中国中医骨伤科杂志》
CAS
2009年第8期32-34,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
锁钉加压钢板
带锁髓内钉
克氏针
肱骨外科颈骨折
Locking compression plate
Intramedullary nail
Kirschner wire
Surgical neck fractures of the humerus
