摘要
目的 观察肱骨近端骨折解剖锁定钢板内固定术中有无内侧柱支撑与其术后放射学参数变化及肩关节功能之间的关系。方法 回顾性分析自2012-01—2014-12获得完整随访的59例肱骨近端骨折,所有患者均采用肱骨近端解剖锁定钢板内固定,根据术中肱骨近端有无内侧柱支撑分为内侧柱支撑组（31例）及非内侧柱支撑组（28例）。观察2组术后肱骨头高度丢失、内翻角度及Constant肩关节功能评分。结果 59例术后均获得随访,随访时间平均12.5（6~24）个月。末次随访时,内侧柱支撑组肱骨头高度丢失0.149~4.761（1.527±1.042）mm,内翻角度0.046°~6.772°（2.150±1.802）°,Constant肩关节功能评分（78.129±7.527）分。非内侧柱支撑组肱骨头高度丢失0.343~5.317（2.501±1.290）mm,内翻角度1.429°~22.978°（10.870±4.217）°,Constant肩关节功能评分（65.250±7.801）分。非内侧柱支撑组肱骨头高度丢失（t=3.206,P=0.002）及内翻角度（t=9.962,P〈0.001）明显高于内侧柱支撑组,内侧柱支撑组Constant肩关节功能评分明显高于非内侧柱支撑组（t=6.451,P〈0.001）。结论 肱骨近端骨折解剖锁定钢板内固定术中内侧柱支撑对于维持术后肱骨头高度及颈干角、改善肩关节功能具有重要的意义。
Objective To observe the correlation between whether medial column support was used in treatment of proximal humeral fractures with anatomical locking plate fixation during operation with postoperative radiographic parameters and shoulder function. Methods A retrospective analysis was conducted of the eligible 59 patients with proximal humeral fractures in our institution between January 2012 and December 2014. Proximal humeral anatomical locking plate was used in all patients. According to whether medial column support was used for treatment of proximal humeral fractures, the patients were devided into a group of adequate medial column support （31 cases） and a group of inadequate medial column support（28 cases）. Postoperative humeral head height loss, humeral head inversion angle and Constant scores of the shoulder function were observed. Results All the patients obtained a mean follow-up of 12.5 months （range from 6 to 24 months）. At the last follow-up, humeral head height loss was 0.149-4.761 （1.527±1.042）mm, humeral head inversion angle was 0.046°-6.772°（2.150±1.802）° and Constant scores of the shoulder function was （78.129±7.527） in the group of adequate medial column support. However, in the inadequate medial column support group, humeral head height loss was 0.343-5.317 （2.501±1.290） mm, humeral head inversion angle was 1.429°-22.978°（10.870±4.217）° and Constant scores of the shoulder function was （65.250±7.801）. The group of inadequate medial column support had significantly higher humeral head height loss（t =3.206, P =0.002） and humeral head inversion angle（t =9.962,P 〈0.001）, but its Constant scores of the shoulder function（t =6.451 ,P 〈 0.001） was significantly lower than that of the adequate medial column support group. Conclusion To maintain the postoperative humeral head height and head-shaft angle, and improve the shoulder function, medial column support of ,proximal humeral fractures treated with anatomical locking plate fixation duri
出处
《中国骨与关节损伤杂志》
2016年第1期44-47,共4页
Chinese Journal of Bone and Joint Injury
关键词
肱骨近端骨折
锁定钢板
内固定
肱骨头高度
内翻角度
Constant肩关节功能评分
Proximal humeral fractures
Proximal humeral anatomical locking plate
Internal fixation
Humeral head height
Humeral head inversion angle
Constant scores of the shoulder function
