小针刀配合手法松解治疗肱骨近端骨折术后肩关节粘连疗效分析

The Analysis of Effect on Treating Adhesive Shoulder after Proximal Humeral Fractures by Needle Knife Combined with Manipulation

[目的]观察小针刀配合手法松解治疗肱骨近端骨折术后肩关节粘连的临床效果。[方法]对我院骨科2010年5月至2016年3月收治的61例肱骨近端骨折术后肩关节粘连患者进行回顾性分析,其中治疗组34例,对照组27例,治疗组采用小针刀配合手法松解治疗,对照组单纯在臂丛麻醉下行手法松解。分别采用美国肩肘外科评分(American Shoulder and Elbow Surgeon Scale,ASES)和美国加州洛杉矶大学(University of California,Los Angeles,UCLA)功能评分标准以及视觉模拟评分(Vi245.9sual Analogue Scale,VAS)进行治疗后3周和治疗后3个月肩关节功能评估,观察两组患者治疗效果。[结果]治疗组患者3周后、3月后肩关节ASES评分、ULCA评分和VAS评分均明显高于对照组,差异均有统计学意义(P<0.05,P<0.01)。[结论]小针刀配合手法松解治疗肱骨近端骨折术后肩关节粘连效果明显,能显著提高患者生活质量,具有较高的临床价值。

[Objective]To observe the clinical effect on treating adhesive shoulder after proximal humeral fractures by needle knife combined with manipulation.[Methods]The 61 patients with adhesive shoulder after proximal humeral fractures admitted from May 2010 throught March 2016 were analyzed retrospectively.The patients were divided into treatment group（34 cases） and control group（27cases）. The treatment group adopted needle knife combined with manipulation, while the control group adopted manipulation under brachial plexus anesthesia simply.To evaluate the shoulder function using the American Shoulder and Elbow Surgeon Scale and University of California Los Angeles Scale and Visual Analogue Scale two weeks and three months after the treatment. [Results]The score of ASES, ULCA and VAS was 90.7 ±4.3, 31.5±2.9 and 1.9±0.46 in the treatment group, the score was 69.1±3.9, 23.5±2.1 and3.1±0.37 in the control group three weeks after the treatment. The score of ASES, ULCA and VAS is91.5 ±2.9, 29.9±2.7 and 1.8±0.32 in the treatment group,the score was 59.5±2.1, 18.3±1.9 and 3.2±0.19 in the control group three months after the treatment. The shoulder joint function in the treatment groups was obviously higher than that in the control group. The difference was statistically significant（ P〈0.05）. [Conclusion]It is effective obviously to treat adhesive shoulder after proximal humeral fractures using needle knife combined with manipulation which can improve the quality of life with high clinical value.