摘要
目的:观察切开复位肱骨近端内固定锁定系统内固定配合中药薰蒸治疗复杂肱骨近端骨折的临床疗效。方法:将62例复杂肱骨近端骨折患者随机分为观察组和对照组,每组31例。观察组采用切开复位肱骨近端内固定锁定系统内固定联合中药薰蒸治疗,对照组采用切开复位肱骨近端内固定锁定系统内固定治疗。记录并比较2组患者的骨折临床愈合时间,并于术后1年评价并比较2组患者的Neer肩关节功能评分及其等级。结果:2组患者骨折临床愈合时间比较,差异无统计学意义[(13.9±4.2)周,(14.2±5.6)周,t=0.138,P=0.887];观察组Neer肩关节功能评分高于对照组[(87.3±4.2)分,(82.9±2.9)分,t=2.735,P=0.014]。2组患者Neer肩关节功能评分等级比较,观察组优25例、良3例、可1例、差2例,对照组优17例、良8例、可4例、差2例,观察组优于对照组(Z=-2.010,P=0.044)。结论:对于肱骨近端Neer三、四部分骨折患者而言,虽然切开复位肱骨近端内固定锁定系统联合中药薰蒸与单纯切开复位肱骨近端内固定锁定系统在骨折愈合时间方面无明显差异,但切开复位肱骨近端内固定锁定系统联合中药薰蒸能够明显缓解肩关节疼痛,改善肩关节功能,疗效确切,是治疗复杂肱骨近端骨折的一种较理想的方法,值得临床推广应用。
Objective ： To observe the clinical curative effect of open reduction and internal fixation with proximal humeral internal loc- king system（PHILOS） combined with Chinese herbal steaming and washing therapy in the treatment of complicated proximal humeral frac- tures. Methods：Sixty-two patients with complicated proximal humeral fractures were randomly divided into observation group and control group,31 cases in each group. Patients in the observation group were treated with open reduction and internal fixation with PHILOS com- bined with Chinese herbal steaming and washing therapy, while the others in the control group were merely treated with open reduction and internal fixation with PHILOS. The clinical fracture healing time were recorded and compared between the 2 groups ,and the Neer shoulder performance score and grade were evaluated and compared between the 2 groups 1 year after operation. Results：There was no statistical difference in clinical fracture healing time between the 2 groups （ 13.9 ＋/-4.2 vs 14.2 ＋/-5.6 weeks, t = 0. 138, P = 0. 887 ）. Neer shoul- der performance scores of observation group were higher than that of control group （ 87.3 ＋/- 4.2 vs 82.9 ＋/- 2.9 points, t = 2. 735, P = 0. 014）. Twenty-five patients obtained an excellent result,3 good, 1 fair and 2 poor in the observation group,while 17 patients obtained an excellent result ,8 good ,4 fair and 2 poor in the control group. The observation group surpassed the control group in the grade of Neer shoul- der performance score（ Z = -2. 010 ,P = 0. 044）. Conclusion ：The combination therapy of open reduction and internal fixation with PHILOS combined with Chinese herbal steaming and washing has similar fracture healing time to the monotherapy of open reduction and internal fixa- tion with PHILOS for 3-part and 4-part proximal humeral fractures. However ,the combination therapy can alleviate the shoulder pain obviously and improve the shoulder function, and it is an ideal method for complicated proximal humeral fracture and worthy of popularizing in clinic.
出处
《中医正骨》
2013年第12期24-27,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
肩骨折
肱骨骨折
骨折固定术
内
薰洗
肱骨近端内固定锁定系统
Shoulder fractures
Humeral fractures
Fracture fixation, internal
Steaming washing therapy
Proximal humeral internal locking system
