摘要
目的探讨应用微创锁定加压钢板内固定治疗老年肱骨近端骨折患者的疗效及其对肩关节功能的影响。方法选取2015年11月至2016年10月我院接诊的老年肱骨近端骨折患者90例,采用随机数字表法,将患者分为观察组和对照组,每组45例。两组患者均在肩外侧作一小切口进行闭合复位,对照组在复位基础上应用微创方法予常规锁定钢板进行内固定,观察组则应用微创方法以锁定加压钢板进行内固定。记录两组患者手术相关指标和愈合情况。内固定3个月后,对比患者治疗后Neer评分优良率,对比两组患者不良事件的发生率。结果观察组Neer评分的优良率为95. 56%,明显高于对照组的82. 22%(P <0. 05)。两组患者的术中出血量、手术时间和术后引流量均无明显差异(均P> 0. 05);观察组的骨折预愈合时间、可负重时间和住院时间均明显少于对照组(均P <0. 05)。术后,对照组的螺钉松动、断裂和脱落的发生率均明显高于观察组(P <0. 05)。结论老年肱骨近端骨折患者应用微创锁定加压钢板内固定进行治疗效果显著,可以有效改善患者的肩关节功能,缩短患者的住院时间,促进患者早日康复。
Objective To investigate the clinical effects of minimally invasive locking compression plate fixation in elderly patients with proximal humeral fractures and its effects on shoulder functions. Methods 90 elderly patients with proximal humeral fractures from November 2015 to October 2016 in our hospital were selected as study subjects and were divided into the control group and the observation group according to the random number table, with 45 cases in each. Two groups of patients were performed a closed reduction on the lateral shoulder, while the control group was treated with minimally invasive locking plate for internal fixation on the basis of reduction, and the observation group was treated with minimally invasive locking compression plate. The surgery-related indicators and healing data of the two groups were recorded. After 3 months＇ fixation, the excellent and good rate of Neer score between the two groups were compared. The incidence of adverse events in the two groups was compared as well. Results According to Neer Score, the excellent rate in the observation group was 95.56%, which was significantly higher than that of the control group （82.22%, P 〈0.05）. There was no significant difference in intraoperative blood loss, operative time and postoperative drainage volume between the two groups （ P 〉0.05）. The fracture healing time, weight-bearing time and hospitalization time in the observation group were significantly shorter than that of the control group （all P 〈0.05）.After surgery, the incidence of adverse events in the control group was 13.33%, which was significantly higher than 2.22%
作者
张杰荣
ZHANG Jie-rong(Department of Orthopaedics,Sanya Hospital of Traditional Chinese Medicine,Sanya 572000,Hainan,China)
出处
《中国现代手术学杂志》
2018年第4期270-273,共4页
Chinese Journal of Modern Operative Surgery
关键词
肱骨骨折
锁定加压钢板
肩关节功能
老年人
humeral fractures
locking compression plates
shoulder joint function
aged
