髓内钉和微创钢板在肱骨干骨折内固定治疗中的应用效果对比

Application effect comparison of intramedullary nail and minimally invasive plate in the treatment of humeral shaft fracture for internal fixation

目的比较微创钢板内固定术和髓内钉内固定治疗肱骨干骨折的临床效果,以期找到更安全、高效的治疗方法。方法回顾性分析2013年5月~2015年6月我院收治的72例肱骨干骨折患者的临床资料,将其随机分组,36例采用微创钢板内固定术的患者定为MIPO组,36例采用微创髓内钉内固定术的患者定为MIN组。比较两组的手术时间、术中出血量,骨折愈合时间及并发症发生情况。结果 MIN组的手术时间短于MIPO组,术中出血量少于MIPO组,差异有统计学意义(P<0.01)。两组的骨折愈合时间、肩肘关节评分改善情况、并发症发生率比较,差异无统计学意义(P>0.05)。结论髓内钉内固定术治疗肱骨干骨折较微创钢板内固定术的手术时间缩短,出血量减少,更加高效,降低了感染风险,值得深入探讨。

Objective To compare the clinical efficacy of minimally invasive plating osteosynthesis and minimally in- tramedullary nailing in the treatment of humeral shaft fractures in order to find a safer and more effective therapeutic approach.Methods The clinical data of 72 patients with humeral shaft fractures from May 2013 to June 2015 in our hospital were retrospectively analyzed.The data were evenly divided into two groups in random.36 patients treated by minimally invasive plate for internal fixation were classified into the MIPO group,and the rest 36 patients treated by in- tramedullary nail were categorized into the MIN group.The operation time,intraoperative amount of bleeding,healing time of bone fracture,and occurrence of complications in the two groups were compared.Results The operation time in the MIN group was shorter than that in the MIPO group,and intraoperative amount of bleeding in the MIN group was less than that in the MIPO group,with statistical differences （P〈0.01）.There were no significant difference in the healing time of bone fracture,score of shoulder and elbow joints improvement,or incidence of complications between the two groups （P〉0.05）.Conclusion In the treatment of humeral shaft fractures,minimally intramedullary nailing is more effi- cient and can shorten the operation time,decrease the amount of bleeding,and reduce the risk of infection in comparison with those by minimally invasive plating o＇steosynthesis,which needs further exploration.