不同内侧柱支撑重建对锁定钢板固定治疗肱骨近端骨折的影响

Influence of different medial column support reconstruction on treatment of locking plate fixation on fractures of the proximal humerus

目的 探讨内侧柱支撑重建的不同部位对锁定钢板治疗肱骨近端骨折的疗效及预后的影响.方法 选取2005年10月～ 2013年10月使用锁定钢板治疗的260例骨折患者,按肱骨近端内侧柱支撑重建情况进行分组：A组120例,B组24例,C组34例以及D组82例.在最后一次随访后对各组患者恢复情况进行评分.结果 A组、B组,C组以及D组的Constant得分分别是（81.5±12.8）、（74.5±9.9）、（68.5±12.3）和（67.5±10.9）分,VAS评分为（1.5±1.9）、（1.7±1.5）、（2.5±2.3）和（3.3±2.5）分,组间差异均有统计学意义（均P＜0.05）.结论 采用锁定钢板治疗肱骨近端骨折时,在骨皮质支撑重建具有较好的稳定性和固定效果.当发生内侧粉碎性骨折或者内侧骨皮质较难复位时,也可以使用多枚内侧支撑螺钉重建肱骨近端内侧柱支撑,可以大大增强其稳定性.

Objective To explore the influence of different medial column support reconstruction on treatment of locking plate fixation on fractures of the proximal humerus.Methods 260 fracture patients treated with locking plate were divided into Group A （120 cases）,Group B （24 cases）,Group C （34 cases） and Group D （82 cases） according to different medial column support reconstruction.The recovery of patients was scored.Results The Constant score of Group A,Group B,Group C and Group D were 81.5±12.8,74.5±9.9,68.5±12.3 and 67.5-±-10.9.The VAS score of Group A,Group B,Group C and Group D were 1.5±1.9,1.7±1.5,2.5±2.3 and 3.3±2.5.Conclusion When using locking plate for treatment of fractures of the proximal hummers,the bone cortex support reconstruction has stability and fixed effects.When fractures occur inside or medial cortical bone harder reset,you can use multiple pieces medial support screws reconstruction of the proximal hummers medial column support and greatly enhance stability.