两种入路治疗肱骨外科颈骨折疗效比较分析.docVIP

两种入路治疗肱骨外科颈骨折疗效比较分析 　　摘要：目的 探讨经三角肌入路及胸大肌三角肌入路治疗肱骨外科颈骨折的临床疗效。方法 2009年1月～2014年12月我院采用经三角肌入路有限切开复位内固定治疗肱骨外科颈骨折26例；采用三角肌胸大肌入路34例，两组均采用锁定钢板内固定肱骨近端骨折。比较两组患者手术时间、末次随访时肩关节功能评分有无差异。结果 两独立样本t检验显示经三角肌入路组患者的手术时间、术中出血量均少于经三角肌胸大肌入路组（P0.05）。结论 经三角肌入路应用锁定钢板治疗肱骨外科颈骨折具有复位简单、微创、组织侵袭小的优点，有利于术后早期功能锻炼，是一种安全、微创、有效的治疗方法。 　　关键词：肱骨外科颈骨折；锁定钢板；经三角肌入路；三角肌胸大肌入路 　　中图分类号：R 683.1；R687.3 　　The Clinical Result Comparison in Humeral Surgical Neck Fractures Treating with Open Reduction 　　and Internal Fixation in Different Approach 　　SHEN Xin，LIAO Jian-ping，GONG Shi-guo，LIU Mu-zi，YANG Hai-long 　　（Department of Orthopaedics，Jiujiang First Peoples Hospital，Jiujiang 332000，Jiangxi，China） 　　Abstract：Objective Investigation of the clinical result in the treatment of humeral surgical fractures with limited incision deltoid-splitting approach and deltopectoral approach. Methods From January 2009 to December 2014， there are 26 cases of proximal humeral fractures are treated with open reduction and internal fixation deltoid-splitting approach in our hospital. And 34 cases are deal with deltopectoral approach. All fractures are fixed with locking plates. Compare the surgery time， bleeding volume and Constant-Murley score in the last follow-up between the two different approaches.Results The average postoperative follow-up is 18.9 months， compare with deltopectoral approach， the deltoid-splitting approach is better in surgery time， bleeding volume， LOS， （P0.05）， there is no significant statistical difference in Constant-Murley score in the two groups.Conclusion Limited incision deltoid-splitting approach with locking plate internal fixation for proximal humeral fractures have the following advantages， easy for reduction， minimal invasion and less tissue damage， and its benefit for early postoperative rehabilitation， its a safe， minimally-invasive and efficient treatment. 　　Key words：Humeral surgical fractures； Locking plate； Deltoid-splitting approach；Deltopectoral approach 　　肱骨外科颈骨折在临床上非常常见，治疗方法主要包括