锁定髓内针系统及锁定钢板治疗老年肱骨近端骨折临床比较分析.docVIP

锁定髓内针系统及锁定钢板治疗老年肱骨近端骨折临床比较分析 　　[摘要]目的 比较锁定髓内针系统与锁定钢板治疗老年肱骨近端骨折的临床效果。方法 分析广州市中西医结合医院2014年2月～2016年2月收治的48例老年肱骨近端骨折患者的临床资料，依据治疗措施不同进行分组，锁定髓内针系统组24例和锁定钢板组24例。观察两组患者的手术相关指标、术后Neer评分、术后并发症情况。结果 锁定钢板组患者的切口长度、术中出血量、手术时间、愈合时间高于锁定髓内针组，差异有统计学意义（P0.05）。两组患者手术后固定松动或断裂、关节活动障碍或者疼痛、骨折不愈合或者延迟愈合发生率差异均无统计学意义（P0.05）。结论 锁定髓内针系统治疗老年肱骨近端骨折，创伤小，恢复快，值得临床推广应用 [关键词]锁定髓内针系统；锁定钢板；老年肱骨近端骨折 [中图分类号] R683.41 [文献标识码] A [文章编号] 1674-4721（2017）04（c）-0064-03 [Abstract]Objective To compare the clinical effect of locking intramedullary pin system and locking plate treating elderly proximal humerus fracture.Methods Clinical data of 48 elderly patients with proximal humerus fracture in Integrated Chinese and Western Medicine Hospital from February 2014 to February 2016 were analyzed，and they were divided into two groups by different treatment methods：locking intramedullary pin system group （24 cases） and locking plate group （24 cases）.The operation correlation index，Neer score after operation，postoperative complications between two groups were observed.Results The incision length，intraoperatve blood soss，operation time，healing time of locking plate group were higher than those of locking intramedullary pin system group，and the differences were statistical significance （P0.05）.There was no statistical difference in the internal fixation loosening or breakage，articular dyskinesia or pain，nonunion or delayed union rate between two groups （P0.05）.Conclusion Locking intramedullary pin system treating elderly proximal humerus fracture and its injury is little，recovery is quick.It is worthy of clinical promotion and application. [Key words]Locking intramedullary pin system；Locking plate；Elderly proximal humerus fracture 股骨近端骨折是老年常?的外科疾病，其发生率占全身骨折发生率的9%左右，多是由于间接性暴露损伤造成的，由于肱骨的生理位置比较特别，患者在预后恢复效果较差，容易留下功能康复性障碍[1-2]。临床上肱骨近端骨折治疗主要包括保守治疗和手术治疗。一些移位较小的股骨近端骨折患者可以通过保守治疗获得比较理想的效果，但是对于骨折端移位比较明显的患者，通过手术治疗可以更好地进行解剖复位，获得较好的预后恢复[3-4]。手术复位后牢固的固定方式和股骨近端骨折患者预后恢复有密切关系，锁定髓内针、锁定钢板是临床上常用的固定治疗老年肱骨近端骨折方法[5-6]。本研究通过对广州市中西医结合医院