摘要
背景:肱骨近端骨折的发生率较高,手术治疗较常用,经三角肌入路结合锁定接骨板治疗的相关报道较少见。目的:探讨经三角肌入路结合锁定接骨板治疗肱骨近端骨折的近期临床疗效。方法:选取2012年10月至2015年10月于我院诊治的肱骨近端骨折患者92例,采用数字随机法分为两组,对照组46例患者经三角肌胸大肌间隙入路结合锁定接骨板治疗,观察组46例患者经三角肌入路结合锁定接骨板治疗,比较两组手术指征、近期临床疗效、并发症。结果:与术前比较,术后两组VAS评分降低,Neer评分、Constant Murley评分增加(P<0.05)。与对照组比较,观察组术后VAS评分降低[(2.2±0.3)分vs(1.3±0.2)分],Neer评分[(84.2±5.7)分vs(93.4±4.1)分]、Constant Murley评分[(85.2±4.3)分vs(94.5±3.0)分]升高;切口长度[(13.1±0.9)cm vs(7.2±0.8)cm]缩小,手术时间[(67.1±6.9)min vs(54.2±8.7)min]、术中出血量[(217.3±20.5)ml vs(153.6±13.8)ml]、术后引流量[(118.2±6.0)ml vs(85.4±7.1)ml]、术后住院时间[(8.3±1.4)d vs(6.9±1.2)d]减少;骨折愈合时间[(11.3±0.8)周vs(9.2±0.7)周]缩短(P<0.05)。与对照组比较,观察组近期临床疗效更好,并发症发生率(15.2%vs 2.2%)降低(P<0.05)。结论:经三角肌入路结合锁定接骨板治疗肱骨近端骨折的近期临床疗效显著,肩功能改善明显,疼痛轻且安全性高,值得临床推广使用。
Background： The incidence of proximal humeral fracture is very high. Surgical treatment is commonly used. The treatment of locking plate through deltoid approach has been rarely reported. Objective： To investigate short-term clinical effect of locking plate via deltoid approach for proximal humeral fractures. Methods： A total of 92 patients with proximal humeral fractures were treated in our hospital from October 2012 to October 2015 and divided into two groups by digital random method. Of them, 46 patients were treated by delto-pectoral approach（control group）, and the other 46 patients were treated by deltoid approach（observation group）. Surgical indications, short-term clinical efficacy and complications were compared between the both groups. Results： Postoperative VAS score decreased, while Neer score and Constant Murley score increased in two groups（P〈0.05）. Postoperative VAS score（1.3±0.2 vs 2.2±0.3） was lower, but Neer score（93.4±4.1vs 84.2 ± 5.7） and Constant Murley score（94.5 ± 3.0 vs 85.2 ± 4.3） were higher in observation group than those in control group（P〈0.05）. Incision length（[7.2±0.8] cm vs [13.1±0.9] cm）, operation time（[54.2±8.7] min vs [67.1±6.9] min）, intraoperative blood loss（[153.6±13.8] ml vs [217.3±20.5] ml）, postoperative drainage volume（[85.4±7.1] ml vs [118.2±6.0] ml）,postoperative hospital stay（[6.9 ± 1.2] d vs [8.3 ± 1.4] d） and fracture healing time（[9.2 ± 0.7] weeks vs [11.3 ± 0.8] weeks）were lower in observation group than those in control group（P〈0.05）. The incidence of complications（2.2% vs 15.2%） was lower in observation group than that in control group（P〈0.05）. Conclusions： There are significant improvement of shoulder function, less pain and higher security when locking plate is used in the treatment of proximal humeral fractures through deltoid approach. Therefore, it is worthy of clinical use.
出处
《中国骨与关节外科》
2017年第3期224-227,共4页
Chinese Journal of Bone and Joint Surgery
