微创钢板固定术与带锁髓内针固定术治疗肱骨干中上端骨折的临床疗效分析

The Effect of Minimally Invasive Plate Osteosynthesis and Intra-medullary Locking Nail Fixation in the Treatment of Upper Humeral Fracture

目的探讨微创钢板固定术与带锁髓内针固定术治疗肱骨干中上端骨折临床疗效。方法对2008年至2011年收入我院的73例肱骨干中上端新鲜骨折患者,随机分为对照组和实验组。对照组35例,采用微创钢板固定术,实验组38例,采用带锁髓内针固定术。结果对照组手术时间(125±29)min,手术出血量(148±44)mL,实验组手术时间(93±29)min,手术出血量(72±35)mL。对照组手术时间、手术出血量均大于实验组,差异显著(P<0.05);对照组愈合时间(10.2±1.9)周,肩关节评分(85±4),实验组愈合时间(10.4±2.1)周,肩关节评分(86±5),相比无显著差异(P>0.05)。结论两种方法都能确定较好疗效,但是带锁髓内针固定术手术时间短,出血少,步骤简便,更适合在基层单位推广。

Objective To explore the clinical effect of minimally invasive plate osteosynthesis and intra-medullary locking nail fixation in the treatment of upper humeral fracture.Methods 73 cases of fresh patients with the upper humeral fracture in our hospital from 2008 to 2011 were selected as objects and they were randomly divided into two groups,35 cases were in the control group and they were taken minimally invasive plate osteosynthesis,38 cases were in the experiment group and they were taken intra-medullary locking nail fixation.Results The average length of operation in the control group was（125± 29）min and the bleeding volume was（148±44）mL,（93±29）min and（72±35）mL in the experiment group.The length of operation and the bleeding volume of control group were more than experiment group,the difference was statistically significant（P0.05）.The healing time in the control group was（10.2± 1.9）weeks and the shoulder score was（85±4）,（10.4±2.1）weeks and（86±5） in the experiment group,the difference was no statistically significant（P0.05）.Conclusion They all have great clinical effect,but intra-medullary locking nail fixation had the advantage of shorter time of operation,the lower bleeding volume and simple procedure.So it is suitable to be widely using in the clinic.