摘要
目的探讨肱骨后外侧或前外侧钢板治疗肱骨中下段关节外骨折对手术指标、骨折愈合及远期肘关节功能的影响。方法回顾性分析2020年8月-2021年9月收治的98例肱骨中下段关节外骨折患者临床资料,根据手术入路途径,将采用肱骨后外侧钢板治疗的55例纳入后外侧治疗组(A组),将采用肱骨前外侧钢板治疗的43例纳入前外侧治疗组(B组),比较两组手术指标(手术时间、术中出血量、术后下床时间、住院时间)和术后骨折愈合时间;比较两组术后6个月肘关节伸直角度、屈曲角度和Mayo肘关节功能(MEPS)评分变化;术后随访6个月,统计两组并发症发生情况。结果A组手术时间、术中出血量、术后下床时间、住院时间和并发症总发生率均低于B组(P<0.05);A组术后6个月MEPS评分高于B组(P<0.05);两组术后骨折愈合时间、术后6个月肘关节伸直角度、屈曲角度比较差异无统计学意义(P>0.05)。结论肱骨前外侧和后外侧钢板治疗肱骨中下段关节外骨折疗效均明显,但后外侧钢板治疗术中创伤小,肘关节功能恢复更佳,术后并发症少,值得临床推广。
Objective To study the effects of posterolateral or anterolateral plate treatment on surgical indicators,fracture healing,and long-term elbow function in the treatment of extra-articular fractures of the middle and lower humerus.Methods The clinical data of 98 patients with extra-articular fractures of the middle and lower humerus admitted to the hospital from August 2020 to September 2021 were retrospectively analyzed.According to the surgical approach,55 patients treated with posterolateral humeral plate were included in posterolateral treatment group(group A),and 43 patients with anterolateral humeral plate treatment were enrolled as anterolateral treatment group(group B).The surgical indicators(surgical time,intraoperative blood loss,postoperative ambulation time,hospital stay)and postoperative fracture healing time and changes in elbow extension angle,flexion angle and Mayo elbow performance scale(MEPS)score at the 6th month after surgery were compared between two groups.The patients were followed up for 6th month after surgery,and the occurrence of complications of two groups were counted.Results The surgical time,intraoperative blood loss,postoperative ambulation time,hospital stay and total incidence rate of complications in group A were significantly shorter or lower than those in group B(P<0.05).The MEPS score in group A was higher than that in group B at the 6th months after surgery(P<0.05).There were no statistically significant differences in fracture healing time after surgery and elbow extension angle and flexion angle at the 6th month after surgery between two groups(P>0.05).Conclusion Both anterolateral humeral plate and posterolateral humeral plate are effective in the treatment of extra-articular fractures of the middle and lower humerus,but posterolateral plate treatment has smaller intraoperative trauma,better recovery of elbow function and fewer postoperative complications,thus it is worthy of clinical promotion.
作者
邵赟
刘爱国
SHAO Yun;LIU Aiguo(Department of Orthopedics,The First Affiliated Hospital of Henan University,Kaifeng,Henan,475000,China)
出处
《实用手外科杂志》
2023年第3期318-321,共4页
Journal of Practical Hand Surgery
基金
2019年河南省医学科技攻关计划(项目编号:LHGJ20190519)。
关键词
后外侧钢板治疗
前外侧钢板治疗
肱骨中下段关节外骨折
远期肘关节功能
Posterolateral plate treatment
Anterolateral plate treatment
Extra-articular fractures of the middle and lower humerus
Long-term elbow function
