摘要
目的：回顾分析应用接骨板螺钉系统、不扩髓肱骨髓内钉系统对肱骨中上段骨折的临床治疗效果。方法：2009年1月~2012年12月,收治肱骨中上段骨折31例。术后随访摄肱骨X光片评价愈合的情况,并应用ASES进行功能评分。结果：所有患者均获随访,随访过程中未发现任何与内固定物有关的并发症。接骨板组骨折愈合时间（7.5±1.2）个月,髓内钉组骨折愈合时间（5.8±1.0）个月,两组比较差异有统计学意义（P〈0.01）。接骨板组与髓内钉组术后10个月ASES评分优良率分别为：89.47%、91.66%,两组ASES评分优良率比较差异无统计学意义（P=0.07）;其中内固定拆除术后2个月ASES功能评分：接骨板组12例优良率83.33%;髓内钉组2例功能评分：一般。结论：在严格选择手术适应症,规范手术操作,结合术后科学康复训练的前提下,采用接骨板和髓内钉系统均是治疗肱骨中上端骨折有效的治疗方式。髓内钉系统具有手术创伤小、骨折愈合快等优势,术后无特殊不适不建议将髓内钉取出。
Objective： Retrospective analysis for the operation of middle upper section of humeral fracture fixation by plate and screw system or unreamed humeral nail（UHN） system. Methods： From January 2009 to December 2012, 31 cases of the humeral fractures in the proximal two thirds part were treated with operation,plate and screw system（plate group, n = 19） and UHN（UHN group, n = 12）. X-ray film and ASES function scores were used to evaluate the fracture healing after operation. Results： All patients were followed up. No complication concerning with hardware was found during follow-up. Fracture healing time of plate group was 7.5± 1.2 months, while 5.8 ± 1.0 months in UHN group（P〉0.01）. Ten months later, the excellent and good rate of the ASES rating scale was 89.47% in plate group and 91.66% in UHN group; two months after removing the internal fixation, the excellent and good rate of the ASES rating scale was 83.33% in plate group（12 cases）, while general in UHN group（2 cases）. The difference of the excellent and good rate of the ASES rating scale had no statistical significance between the two groups（P﹥0.05）. Conclusion： Treatments of the upper humerus fractures with plate and screw system or UHN system could be the effective methods as long as the operative indication was strictly selected, the standard practices of operation were carried out and the rehabilitation after operation was included. The UHN has the advantage of minimal invasion and rapid healing. It is not recommended to remove UHN unless there are special symptoms after operation.
出处
《泸州医学院学报》
2015年第1期53-57,共5页
Journal of Luzhou Medical College
