肱骨外科颈骨折并肩关节脱位的临床研究

Clinical research on humerus surgical neck fracture joint shoulder dislocation

目的:研究手术治疗肱骨外科颈骨折合并肩关节脱位的有效方法。方法:按照计算机数字表法将99例肱骨外科颈骨折合并肩关节脱位患者随机分为A、B、C三组,各33例,A组采用切开交叉克氏内固定治疗,B组采用切开钢板内固定治疗,C组采用切开外展支架固定治疗,比较三组患者术后3、7、14dVAS评分,比较患者下床活动时间、骨折愈合时间、平均治疗费用、并发症发生率,术后6个月肩关节功能。结果:A组患者术后3、7、14d明显低于B组和C组,组间比较差异具有统计学意义(P<0.05)。A组患者下床时间、骨折愈合时间、平均治疗费用、并发症发生率均低于B组和C组,Neer评分高于B组和C组,组间比较差异具有统计学意义(P<0.05)。结论:切开交叉克氏内固定治疗手法闭合整复失败的肱骨外科颈骨折合并肩关节脱位患者具有骨折愈合快,治疗成本和并发症发生率低等优点,可优先选用。

Objective： To study the effective method of treating humerus surgical neck fracture joint shoulder dislocation. Methods： According to the computer digital table method, 99 patients of humerus surgical neck fracture joint shoulder dislocation were randomly divided into A, B, C three groups, 33 in each group. Group A was given crossed-pin interior fixation, Group B was given open reduction and internal fixation, Group C was given open reduction upper limbs abducens support fixed treatment. Compare VAS scores in three groups postoperative 3, 7, 14 days, out-of-bed activity time, fracture healing time, average treatment costs, complications, and postoperative 6 months of shoulder joint function. Results： VAS scores in group A postoperative 3, 7, 14 days were obviously lower than that in group B and group C, with significant differences （P〈0.05）. Group A has lower bed time, fracture healing time, average treatment costs and complication rate were lower than those in group B and group C. Neer scores in group A was higher than that in group B and group C, with significant differences （P〈0.05）. Conclusion： Crossed-pin interior fixation treatment has quick healing time, lower treatment cost and lower complication occurence rate on treating humerus surgical neck fracture joint shoulder dislocation.