摘要
目的 探讨微创空心螺钉内固定治疗肱骨大结节骨折的临床优势与不足.方法 回顾性分析2014年9月至2016年2月48例单纯肱骨大结节骨折患者的临床资料,按微创内固定手术方法的不同分为观察组（微创空心螺钉组）与对照组（微创锁定钢板组）,每组各24例.比较两组患者的手术时间、术中出血量、愈合时间、肩关节功能评分、术后疼痛及并发症发生率等情况.结果 观察组术后疼痛评分及骨折愈合时间显著低于对照组,差异有统计学意义（t=10.820,6.527,P〈0.05）.观察组术后3个月肩关节功能优良率87.5％,显著高于对照组66.7％,差异有统计学意义（χ2=8.565,P〈0.05）;术后6个月肩关节功能评分,差异无统计学意义（χ2=5.912,P〉0.05）.两组并发症发生率,差异有统计学意义（χ2=8.565,P〈0.05）.结论 对于单纯肱骨大结节骨折患者应用微创空心螺钉及锁定钢板内固定治疗均可以取得较好的治疗效果,但空心螺钉具有全面牢固固定劈裂的骨折端,术后短期内肩关节功能恢复快,不良反应发生率低等优点,值得临床推广应用.
Objective To investigate the clinical advantages and disadvantages ofminimany invasive internal fixation by cannulated compression screws in the treatment of fracture of great tubercle. Methods The clinical data of 48 patients with simple fracture of great tubercle were reviewed and analyzed from September 2014 to February 2016 . The patients were divided into observation group according to the different methods of minimally invasive internal fixation. （ minimally invasive cannulated compression screws group ） and control group （ mini-invasive locking plate group ） , with 24 cases in each group. The operative time, intraoperative bleeding, healing time, shoulder function score, postoperative pain and incidence of complications and so on of the two groups were compared. Results It was obvious that the postoperative pain score and fracture healing time in the observation group were significantly lower than those in the control group, and the difference was statistically significant. （ t= 10.820, 6.527, P〈0.05 ） The excellent rate of evaluation of shoulder joint function in the observation group 3 months after operation was 87.5%, which was significantly higher than 66.7% of the control group and the difference was statistically significant. （ X 2=8-565, P〈0.05 ） There was no significant difference in shoulder function score 6 months after operation. （ X 2=5.912, P〉0.05 ） The incidence of complications in the two groups was statistically significant. （ X 2=8-565, P〈0.05 ） . Conclusion For the patients with simple fracture of great tubercle, the application of the internal fixation ofminimany invasive cannnlated compression screws and minimally invasive locking plate can achieve better results, but the cannulated compression screws can fix the fracture end completely and firmly. With the advantages such as short term recovery of shoulder function and the low incidence of adverse reactions, it is worthy of clinical application.
出处
《浙江临床医学》
2018年第5期862-863,865,共3页
Zhejiang Clinical Medical Journal
关键词
微创
空心螺钉
内固定
肱骨大结节骨折
Minimally invasive Cannulated compression screws Internal fLxation Fracture of great tubercle
