摘要
目的比较前外侧入路与前侧入路前内侧接骨板内固定治疗肱骨中下段骨折的临床疗效及并发症发生率。方法回顾性分析自2010—01—2013—10诊治的56例肱骨中下段骨折的临床资料，其中Ⅰ组30例采用前外侧入路内固定，Ⅱ组26例采用前侧入路前内侧固定。结果Ⅰ组获得随访12—22（15．63±2．62）个月，Ⅱ组获得随访12—22（16．22±2．88）个月。2组在手术时间、术中出血量方面的差异有统计学意义（P〈0．05）。Ⅰ组骨折愈合时间10～18（14．87±2．32）周，肘关节最大屈曲范围134°-146°（138．60±3．27）°，肘关节最大伸直范围0°-8°（4．87±1．91）°，Mayo肘关节功能评分（MEPs评分）70～100（88．04±7．72）分，Neer肩关节功能评分75～100（89．13±4，32）分。Ⅱ组骨折愈合时间10～19（15．06±2．22）周，肘关节最大屈曲范围130°-145°（137．95±4．15）°，肘关节最大伸直范围0°-9°（5．15±2．33）°，MEPS评分70～100（85．15±7．66）分，Neer肩关节功能评分75～100（88．54±2．30）分。2组在骨折愈合时间、肘关节最大屈伸范围及MEPS、Neer肩关节功能评分方面差异无统计学意义（P〉0．05）。Ⅱ组并发症发生率低于Ⅰ组，差异有统计学意义（P=0．04）。结论前外侧入路与前侧入路前内侧固定均能有效治疗肱骨中下段骨折，但后者术中出血量及手术时间均较短，且并发症发生率更低。
Objective To compare treatment results and complication rates between anterolateral and anterior approach anteromedial plate osteosynthesis in surgical treatment of mid-lower humeral shaft fractures. Methods Between January 2010 and October 2013, a total of 56 patients with mid-lower humeral shaft fractures were treated by anterolateral and anterior approach anteromedial plate osteosynthesis. Of the patients, 30 were operated by a anterolateral approach （group Ⅰ ） and 26 were operated by a anter/or approach and anteromedial plate osteosynthesis（group Ⅱ）. Results The average of followup in group Ⅰ was （15.63±2.62） months （range, 12-22 months）, and （16.22±2.88）months（range, 12-22 months） in group Ⅱ. There was statistically significant difference between two groups in the operation time, intraoperative bleeding time （P 〈0.05）. In group Ⅰ, the mean time to bony union was （14.87±2.32）weeks（range, 10-18 weeks）, the mean degrees of elbow flexion was （138.60±3.27）°（range, 134°-146°）, the mean degrees of elbow extension were （4.87±1.91）°（range, 0°-8°）, and the mean points of MEPS were （88.04±7.72）points（range, 70-100 points）, the mean points of Neer shoulder functional score were （89.13±4.32） points（range, 75-100 points）. In group Ⅱ, the mean time to bony union was （15.06±2.22）weeks（range, 10-19 weeks）, the mean degrees of elbow flexion was （137.95±4.15）° （range, 130°-145°）, the mean degrees of elbow extension was （5.15±2.33）° （range, 0°-9°）, and the mean points of MEPS were （85.15±7.66）points （range, 70-100 points）, the mean points of Neer shoulder functional score were （88.54±2.30）points（range, 75-100 points）. There was no significant difference in the bony union, range of elbow flexion, range of elbow extension and MEPS, Neer shoulder functional score between two groups （P 〉0.05）. The overall complication rate in group Ⅰ was higher than that in group Ⅱ （P =0.04）
出处
《中国骨与关节损伤杂志》
2015年第7期709-712,共4页
Chinese Journal of Bone and Joint Injury
基金
军区医学科技创新经费资助项目(11Z022)
关键词
肱骨中下段骨折
桡神经损伤
前外侧入路
前侧入路
前内侧固定
Humeral fractures
Radial nerve injury
Anterolateral approach
Anterior approach
Anteromedial plating
