摘要
目的观察经三角肌入路与经三角肌胸大肌间沟入路治疗老年移位的肱骨近端骨折的近期疗效。方法将2011年1月至2013年12月收治的40例肱骨近端骨折患者随机分为经三角肌入路组与经三角肌胸大肌间沟入路组,每组20例。比较两组患者的住院时间、手术时间、出血量、并发症、术后肩关节功能及疼痛。结果所有患者均获得术后12个月随访。经三角肌入路组住院时间、手术时间、术中出血量及术后引流量均显著低于经三角肌胸大肌间沟入路组(P<0.001);伤口并发症经三角肌入路组1例,经三角肌胸大肌间沟入路组4例,两组比较差异有统计学意义(P=0.003)。术后次日、3 d、7 d、2周、1个月经三角肌入路组Constant Murley评分均优于经三角肌胸大肌间沟入路组,但术后3个月以后两组Constant Murley评分差异均无统计学意义。术后次日、3 d、7 d、2周经三角肌入路组VAS评分均优于经三角肌胸大肌间沟组,但术后1个月以后两组Constant Murley评分差异无统计学意义。两组各有1例近端螺钉松动,但均未出现感染、腋神经损伤、螺钉切出、复位丢失、肱骨头坏死等。结论经三角肌入路治疗老年肱骨近端骨折的短期效果优于经三角肌胸大肌间沟入路,具有住院时间短、手术时间短、出血量少、疼痛轻、肩关节功能恢复快等优点。
Objective To compare the clinical efficacy of the deltoid- split approach with the deltopectoral approach for the treatment of displaced proximal humeral fractures in elderly. Methods Forty patients with proximal humeral fractures were randomized into two groups： 20 patients in the group for the deltoid-split approach and 20 patients in the other group for the deltopectoral approach. The clinic data such as hospital stay, operation time, blood loss, complications,shoulder function and pain were compared. Results All patients were followed up for 12 months. There were significant statistical differences in hospital stay, operation time and blood loss between the two groups（P〈0.001）. Wound complications occurred in 1 patient in the deltoid-split approach and 4 patients in the deltopectoral approach. Deltoid-split and deltopectoral approaches showed similar Constant scores during the 12 months follow up. Conclusion The deltoid- split approach is better than deltopectoral approache for the treatment of displaced proximal humeral fractures in elderly. This approach has shorter hospital stay, shorter operative time and less blood loss when compared with deltoid-split approach.
出处
《北京医学》
CAS
2015年第11期1048-1051,共4页
Beijing Medical Journal
关键词
肱骨近端
骨折
经三角肌入路
老年
Proximal humeral Fracture Deltoid-split approach Elderly
