两种术式(锁定接骨板与三叶型钢板)经胸大肌三角肌间隙入路治疗老年肱骨近端骨折临床对比研究.docVIP

不同入路下锁定接骨板内固定治疗老年肱骨近端骨折临床对比研究 【摘要】目的:探讨经胸大肌三角肌间隙入路与肩外侧入路下行锁定接骨板内固定治疗老年肱骨近端骨折临床疗效及安全性差异。方法：研究对象选取我院2012年4月-2014年9月收治老年肱骨近端骨折患者共170例，采用随机区组法分为A组（85例）和B组（85例），分别给予三叶型钢板和锁定接骨板经胸大肌三角肌间隙入路治疗；比较两组患者手术时间、骨折愈合时间、术后随访Neer评分优良率、治疗前后肩关节活动度及术后并发症发生情况等。结果：B组患者手术时间和骨折愈合时间均显著短于A组（p0.05）；B组患者术后随访Neer评分优良率显著高于A组（p0.05）；B组患者治疗后肩关节活动度优于A组、治疗前（p0.05）；B组患者术后并发症发生率显著低于A组（p0.05）。结论：锁定接骨板经胸大肌三角肌间隙入路治疗老年肱骨近端骨折可有效缩短手术时间，促进肩关节功能恢复，扩大活动范围，并有助于降低术后并发症发生风险，疗效及安全性均优于三叶型钢板。 【关键词】锁定接骨板；三叶型钢板；胸大肌三角肌间隙；肱骨近端骨折 Comparative study of?two kinds of operation scheme by pectoralis major deltoid muscle gap approach in the treatment of elderly patients with proximal humerus fractures Abstract：Objective To investigate the clinical efficacy and safety differences of two kinds of operation scheme by pectoralis major deltoid muscle gap approach in the treatment of elderly patients with proximal humerus fractures including locking compression plate and clover plate. Methods 170 elderly patients with proximal humerus fractures were chosen in the period from April 2012 to September 2014 in our hospital and randomly divided into both group including A group (85 patients) with clover plate and B group (85 patients) with locking compression plate by pectoralis major deltoid muscle gap approach; and the operation time, the fracture healing time, the excellent and good rate of Neer scores with follow-up, shoulder?periarthritis before and after treatment, and postoperative complication?incidence?of 2 groups were compared. Results The operation time and the fracture healing time of B group was significantly shorter than A group （p0.05）. The excellent and good rate of Neer scores with follow-up of B group was significantly better than A group （p0.05）. The shoulder?periarthritis after treatment of B group was significantly better than A group and before treatment（p0.05）. The postoperative complication?incidence of B group was significantly lower than A group（p0.05）. Conclusion Compared with clover plate, locking compression p