摘要
目的探讨锁定钢板固定肱骨近端骨折术中肱骨近端内侧柱支撑重建的临床意义．法问顺性分析2005年6月至2010年12月采用锁定钢板治疗且获得随访的125例肱骨近端骨折患者临床资料，男54例，女71例；年龄18～88岁，平均54．6岁一旨折根据Neer分型：二部分骨折57例，三部分骨折62例，四部分骨折6例。根据术后X线片所示肱骨近端内侧桂支撑重建情况分为2组：内侧柱支撑重建组（重建组，84例）和内侧柱支撑未重建组（朱莺建组，41例）。随访记录并比较两组患者的肩关节功能Constant评分、肱骨头内翻角度、视觉模拟评分（VAS）及并发症发生情况。结果所有患者术后获6—30个月（平均13．6个月）随访。霞建组与未重建组平均Constant评分分别为（77．9±13．0）、（67．3±11．3）分，优良率分别为72．6％、43．9％，平均VAS评分分别为（1．6±2．0）、（3．2±2．4）分，以上项目两组比较差异均有统计学意义（P〈0．05）；重建组术后肱骨头内翻角度（1．2°±3．3°）小于未重建组（4．4°±4．0°），术后并发症发生率（16．6％）、二次手术率（4．8％）均较未重建组（34．1％、17．0％）低，差异均有统计学意义（P〈0．05）。结论锁定钢板同定肱骨近端骨折术中币建肱骨近端内侧杵支撑、骨折端良好复位不仪能使肱骨头得到有效的支撑、预防术后肱骨头内翮及内固定失败，而且术后能取得更满意的疗效。
Objective To evaluate the clinical benefils of reeonstrtn.ling the medial column support in locked plating of proximal humerus fractures. Methods A retrospective analysis was eondt,cted of the eligiHe 125 patients who had undergone locked plating of proximal humerus fracture in our institution between June 2005 and l）ecember 2010. They were 54 men and 71 women, 18 to 88 years of age （average, 54.6 years）. Bv the Neer classification, there were 57 cases of two-part fracture, 62 eases of three-parl fracture and 6 cases of four-part fraeture. One independent examiner evaluated their postoperative radiographs of the shouhler to divide the patimus into a group of adequate medial column reconstruction （84 eases） and a group of inadequate medial column reconstruction （41 cases） . Tile postoperative Constant scores of the shoulder function, hnmeral inversion angles, visual analog scale （VAS） pain scores and complications were compared between the 2 groups. Results All the patients obtained a mean follow-up of 13.6 months （range, from 6 to 30 months） . The clinical outcomes in the group of adequale medial column reconstruction were all sig- nificantly better than those in the group of inadequate media[ enh,mn reconstruction in terms of mean Constant shouhter score （77.9 ±13.0 vs. 67.3 ± 11.3）. excellent to good rate （72.6% vs. 43.9% ）, VAS pain score （ 1.6±2.0 vs. 3.2 ± 2.4）, humeral inversion angle （ 1.2° ± 3.3° vs. 4.4°± 4. 0°）, complications rate （ 16.6% vs. 34. 1% ） and seeondaD＇ ope,＇ation rate （4. 8% vs. 17.0% ） （ P 〈 0. 05）. Conclusion In the loeked plating of proxiuml huments fraett, res, reconstruction of the medial column suppori has benefits of enhaneed mechanical stability of the humeral head, reduced secondary neck-shaft angle loss and fewer implant failure to ensure good clinical outcomes.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2012年第7期561-565,共5页
Chinese Journal of Orthopaedic Trauma
关键词
肩骨折
骨板
骨折固定术
内
Shouhler fi＇aetures
Bone plates
Fracture fixation, internal
