摘要
背景:近年来,肱骨近端锁定钢板临床应用于肱骨近端骨折取得了良好的疗效,但将其应用于肱骨大结节MutchⅡ型(劈裂)骨折的报道较少。目的:探讨切开复位肱骨近端锁定钢板内固定治疗肱骨大结节MutchⅡ型(劈裂)骨折的临床疗效。方法:选择2009年5月至2018年6月西南医科大学附属中医医院收治的MutchⅡ型肱骨大结节患者40例,其中男29例,女11例,依据内固定方式分为2组:观察组接受肱骨近端锁定钢板内固定治疗,对照组接受空心螺钉内固定治疗,每组20例。术后随访骨折愈合与肩关节功能,采用美国肩肘外科医师评分(ASES)、Constant-Murley评分(CMS)、美国加州大学肩关节评分(UCLA)、目测类比评分评估肩关节功能。试验获得西南医科大学附属中医医院伦理委员会批准,伦理号:SWMUTCMJ-2017-09-10。结果与结论:①术后随访1年,未出现钢板或螺钉松动、折断等并发症,观察组出现1例大结节畸形愈合,1例肩关节疼痛;对照组出现3例大结节畸形愈合,2例大结节上移,2例肩关节疼痛;②术后随访1年时,观察组CMS评分、UCLA评分高于对照组(P<0.05),两组间ASES评分、目测类比评分比较差异无显著性意义(P>0.05);③结果表明,肱骨近端锁定钢板内固定治疗肱骨大结节MutchⅡ型骨折能实现坚强固定并恢复大结节骨折的移位,但其并发症仍需重视。
BACKGROUND: In recent years, proximal humeral locking plate has achieved good results in the treatment of proximal humeral fractures. However, there are few reports of locking plate application in Mutch type Ⅱ greater tuberosity split fractures.OBJECTIVE: To exploit the clinical effect of Mutch type Ⅱ greater tuberosity split fractures of proximal humerus with open reduction and internal fixation with locking plate of proximal humerus. METHODS: From May 2009 to June 2018, 40 patients(29 males and 11 females) with Mutch type Ⅱ GT split fractures were treated in the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. They were randomly divided into two groups. The observation group received internal fixation with locking plate of proximal humerus(n=20). The control group received cannulated screw fixation(n=20). The fracture healing and shoulder joint function were followed up after operation. Shoulder joint function was assessed by American Shoulder and Elbow Surgeon(ASES) score, Constant-Murley score(CMS), University of California, Los Angeles(UCLA) shoulder score, and visual analogue scale score. The trial was approved by the Ethics Committee of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University(approval No. SWMUTCMJ-2017-09-10). RESULTS AND CONCLUSION:(1) After 1 year of follow-up, there were no complications such as plate or screw loosening or broken. In the observation group, there were one case of malunion of large tuberosity and one case of shoulder joint pain. In the control group, there were three cases of malunion of large tuberosity, two cases of upward movement of large tubercle and two cases of shoulder joint pain.(2) At 1-year follow-up, the CMS score and UCLA score of the observation group were higher than those of the control group(P < 0.05). ASES score and VAS score showed no significant difference(P > 0.05).(3) The results showed that proximal humeral locking plate internal fixation in the treatment of Mutch Ⅱ type fracture o
作者
刘刚
张宝露
石杰
暴丁溯
曾胜强
邓凯
刘洋
汪国友
扶世杰
Liu Gang;Zhang Baolu;Shi Jie;Bao Dingsu;Zeng Shengqiang;Deng Kai;Liu Yang;Wang Guoyou;Fu Shijie(Department of Orthopedics,Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Center for Orthopedic Diseases Research,Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Academician Workstation in Luzhou,Luzhou 646000,Sichuan Province,China;Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center,Luzhou 646000,Sichuan Province,China;College of Nursing Affiliated to Southwest Medical University,Luzhou 646000,Sichuan Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第18期2863-2868,共6页
Chinese Journal of Tissue Engineering Research
基金
四川省哲学社会科学重点研究基地现代设计与文化研究项目(MD18E014),项目负责人:刘刚。
关键词
骨
固定
植入物
肱骨大结节
MutchⅡ型骨折
钢板
空心螺钉
bone
fixation
implants
greater tuberosity of humerus
Mutch type Ⅱ fractures
plate
cannulated screw
