肱骨外科颈骨折行切开复位三叶草钢板内固定临床治疗观察

Clinical Observation on the Effect of Open Reduction and Internal Fixation with Clover Plate in the Treatment for Surgical Humerus Neck Fracture

目的探讨肱骨外科颈骨折患者切开复位行三叶草钢板内固定手术治疗的效果,以便为临床治疗提供参考依据。方法选取2011年6月至2013年5月阳春市中医院骨科收治的48例肱骨外科颈骨折患者,根据不同的治疗方法分为三叶草钢板组和保守治疗组各24例,其中三叶草钢板组给予三叶草钢板内固定,保守治疗组给予保守治疗,观察两组患者的临床疗效。结果三叶草钢板组患者愈合为优16例,良6例;保守治疗组患者愈合为优11例,良4例,三叶草钢板组患者的疗效明显高于保守治疗组,两组比较差异有统计学意义(P<0.05)。三叶草钢板组术后肩关节受限中度为3例,无重度受限患者;保守治疗组术后肩关节受限中度11例,重度2例,保守治疗组中度及重度受限比例明显高于三叶草钢板组(P<0.05)。结论三叶草钢板内固定治疗肱骨外科颈骨折疗效确切,值得基层医院推广。

Objective To investigate the effects of open reduction and internal fixation with clover plate （CP） in the treatment for surgical humerus neck fracture, in order to provide reference for clinical treatment. Methods A total of 48 cases of patients with surgical humerus neck fractures treated in Department of Orthopedics ,Yangchun Hospital of Traditional Chinese Medicine from Jun. 2011 to May 2013 were divided into clover plate group and the conservative treatment group according to the random number table, with 24 cases in each group. Patients in the clover plate group were given treatment of open reduction and internal fixation with clover plates, and patients in the conservative treatment group received conservative treatment. Curative effects of two groups after treatment were observed. Results There were 16 cases of excellent recovery in clover plate group and 6 cases of good recovery. While in the conservative treatment group,there were 11 cases of excellent recovery, and 4 cases of good recovery. Currative effect of clover plate group was significantly higher than the conservative treatment group, and the difference was statistically significant （ P 〈 0. 05 ）. There were 3 cases of moderate restricted shoulder joint in clover plate group ,but no case of severe restricted shoulder joint. While there were 11 cases of moderate restricted shoulder joint in conservative treatment group with and 2 cases of severe restricted shoulder joint. The ratio of moderate and severe restricted shoulder joint in the conservative treatment group was significantly higher than the clover plate group, the difference was statistically significant（P 〈 0.05 ）. Conclusion The internal fixation with clover plate in the treatment for surgical humerus neck fracture has reliable effectiveness,which is worth promoting in the primary hospitals.