摘要
目的:探讨异体腓骨髓内支撑结合钢板内固定治疗NeerⅣ型肱骨近端骨折的临床疗效。方法:自2017年12月至2020年12月采用异体腓骨髓内支撑结合钢板内固定治疗NeerⅣ型肱骨近端骨折患者12例,男7例,女5例;年龄56~78岁;受伤至手术时间1~7 d。观察患者手术时间、骨折愈合时间及并发症情况,末次随访时采用Constant-Murley评分进行疗效评价。结果:12例患者获得随访,时间20~29个月。所有患者获得骨性愈合,手术切口Ⅰ期愈合,手术时间95~138 min,出血量210~275 ml,骨折愈合时间14~18周。术后2例出现肩关节僵硬,经被动锻炼2周后恢复。所有患者未发生感染、切口愈合不良、内固定物失效(断裂、松动)等并发症。末次随访时,Constant-Murley肩关节功能评分69~89分,优2例,良9例,可1例。结论:采用异体腓骨髓内置入能够为肱骨内侧提供有效支撑,有利于辅助骨折端复位,降低肱骨头内翻塌陷及螺钉穿出致内固定失效等情况出现,显著改善肩关节功能。
Objective To explore clinical effect of allogeneic peroneal bone marrow support combined with plate internal fixation in treating Neer typeⅣproximal humeral fractures.Methods From December 2017 to December 2020,12 patients with Neer typeⅣproximal humeral fractures were treated with allogeneic peroneal bone marrow support combined with plate internal fixation,including 7 males and 5 females,aged from 56 to 78 years old;the time from injury to operation ranged from 1 to7 days.Operative time,fracture healing time and complications during follow-up were observed,and clinical efficacy was evaluated by Constant-Murley score at the latest follow-up.Results All patients were obtained follow up for 20 to 29 months.All patients got bone healing and incisicons were healed at stageⅠ,operative time ranged from 95 to 138 min,blood loss ranged from 210 to 275 ml,fracture healing time ranged from 14 to 18 weeks.Two patients occurred postoperative shoulder stiffness and recovered after 2 weeks of passive exercise.There were no complications such as infection,poor wound healing,and failure(fracture and loosening)of internal fixators occurred.Constant-Murley shoulder function score ranged from 69 to 89 at the latest follow up,2 patients got excellent results,9 good and 1 fair.Conclusion The application of allogeneic fibular bone marrow placement could provide effective support for medial humerus,which is conducive to assisting reduction of fracture end,reducing occurrence of internal fixation failure caused by collapse of humerus head and screw perforation,and significantly improving function of shoulder joint.
作者
孙振国
张占丰
胡文林
夏增兵
SUN Zhen-guo;ZHANG Zhan-feng;HU Wen-lin;XIA Zeng-bing(Department of Orthopaedics,the First People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China)
出处
《中国骨伤》
CAS
CSCD
2024年第3期288-292,共5页
China Journal of Orthopaedics and Traumatology
基金
浙江省医药卫生科技计划项目(编号:2021KY346)。
关键词
异体腓骨
钢板
肱骨近端骨折
Allogeneic fibula
Steel plate
Fracture of proximal humerus
