摘要
目的对比hlios锁定钢板和Multiloc髓内钉治疗肱骨近端骨折的临床效果。方法选取2016年1月~2018年1月我院收治的80例肱骨近端骨折患者作为研究对象,按照随机数字表法将其分为锁定钢板组(38例)与髓内钉组(42例)。锁定钢板组患者采用hlios锁定钢板进行治疗,髓内钉组患者采用Multiloc髓内钉进行治疗。比较两组患者的一般情况、肩关节活动程度、肩关节疼痛和功能障碍指数(SPADI)评分以及并发症发生情况。结果髓内钉组患者的切口长度、手术时长均短于锁定钢板组,术中出血量少于锁定钢板组,差异有统计学意义(P<0.05);两组患者的术中透视次数以及骨折愈合时间比较,差异无统计学意义(P>0.05)。两组患者的初、末次肱骨颈干角,前屈上举以及主动体侧外旋度比较,差异无统计学意义(P>0.05);髓内钉组患者的△颈干角度低于锁定钢板组,差异有统计学意义(P<0.05)。髓内钉组患者的术后SPADI评分低于锁定钢板组,差异有统计学意义(P<0.05)。两组患者均未出现不愈合、肱骨头坏死及骨性关节炎,髓内钉组出现1例肩关节上举疼痛,锁定钢板组出现2例切口感染。两组患者的并发症发生率比较,差异无统计学意义(χ^2=0.46,P=0.50)。X线检查结果显示,Multiloc髓内钉和hlios锁定钢板均能有效固定肱骨近端骨折。结论采用Multiloc髓内钉与hlios锁定钢板治疗肱骨近端骨折效果相当,Multiloc髓内钉在选择切口长度、手术时长、术中出血量以及△颈干角度方面优于hlios锁定钢板,值得临床推广。
Objective To compare the clinical effect of hlios locking plate and Multiloc intramedullary nail in the treatment of proximal humerus fractures.Methods A total of 80 patients with proximal humerus fractures treated in our hospital from January 2016 to January 2018 were selected as the research subjects.They were divided into the locking plate group(38 cases)and the intramedullary nail group(42 cases)according to the random number table method.Patients in the locking plate group were treated with hlios locking plate,and the intramedullary nail group was treated with Multiloc intramedullary nails.The general condition,shoulder joint motion,shoulder pain and dysfunction index(SPADI)score and incidence of complications were compared between the two groups of patients.Results The length of incision and operation time of patients in the intramedullary nail group were shorter than those in the locking plate group,and the intraoperative blood loss was less than that in the locking plate group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the number of intraoperative fluoroscopy and fracture healing time between the two groups(P>0.05).There were no statistically significant differences in the initial and last humeral neck shaft angle,flexion and lift,and active body external rotation between the two groups of patients(P>0.05).The angle of△neck trunk in the intramedullary nail group was lower than that in the locking plate group,and the difference was statistically significant(P<0.05).The postoperative SPADI score of patients in the intramedullary nail group was lower than that in the locking plate group,and the difference was statistically significant(P<0.05).There were no non-union,humeral head necrosis and osteoarthritis in the two groups of patients.One case of shoulder joint pain occurred in the intramedullary nail group,and two cases of incision infection occurred in the locking plate group.There was no statistically significant difference in the incidence rate of complications between the two groups(χ^2=0.46,P=0.50).X-ray examination results showed that Multiloc intramedullary nails and hlios locking plate could effectively fix proximal humeral fractures.Conclusion The use of Multiloc intramedullary nails and hlios locking plate for treating proximal humeral fractures is equivalent.Multiloc intramedullary nails are superior to hlios locking plate in the selection of incision length,operation time,intraoperative blood loss and△neck trunk angle,and are worthy of clinical promotion.
作者
江钦文
赖沛群
黄国鹏
JIANG Qin-wen;LAI Pei-qun;HUANG Guo-peng(Department of Orthopedics,Puning People′s Hospital of Guangdong Province,Puning515300,China)
出处
《中国当代医药》
2020年第20期8-12,共5页
China Modern Medicine
