微创空心钉配合带线锚钉内固定在肱骨大结节骨折患者治疗中的应用

Application of minimally invasive hollow screw combined with suture anchor internal fixation in treating humeral fractures of greater tuberosity

目的探究微创空心钉配合带线锚钉内固定治疗肱骨大结节骨折患者的临床疗效。方法选取收治的42例肱骨大结节骨折患者,分为双联固定组和钢板组,每组21例;双联固定组患者采用微创空心钉联合带线锚钉内固定治疗,钢板组患者采用切开复位钢板内固定治疗,对比两组患者在住院时间、手术时间、术中出血量、骨折愈合时间、并发症发生率的差异,参照Neer评分标准对肩关节功能疗效进行评定。结果双联固定组患者在住院时间、手术时间、术中出血量均低于钢板组,差异有统计学意义(P<0.05)。双联固定组骨折愈合时间为(14.35±1.46)周,钢板组骨折愈合时间为(15.83±1.72)周,双联固定组患者骨折痊愈的时间明显少于钢板组(P<0.05)。双联固定组并发症发生率为19.05%,钢板组患者并发症发生率为23.81%,两组间差异无统计学意义(P>0.05)。双联固定组患者肩关节功能疗效优良率为85.71%,钢板组优良率为71.43%,差异有统计学意义(P<0.05)。结论微创空心钉配合带线锚钉内固定治疗肱骨大结节骨折患者相比切开复位钢板内固定治疗具有手术时间短、术中出血量较少、骨折愈合时间短、肩关节功能优良率高的优势,值得推广应用。

Objective To explore the clinical effect of minimally invasive hollow screw combined with suture anchor internal fix- ation in the treatment of humeral fractures of greater tuberosity. Methods Forty-two cases of humeral fractures of greater tuberosity in our hospital were selected and randomly divided into the double fixed group and plate group,21 cases in each group. The doub- le fixed group adopted minimally invasive hollow screw combined with suture anchor internal fixation treatment, while the plate group adopted the open reduction and plate internal fixation. The hospitalization time, operation time,intraoperative blood loss, fracture healing time and incidence of complications were compared between the two groups. The effect of shoulder joint function was e- valuated by referring to the Neer score standard. Results The hospitalization time,operation time and intraoperative blood loss in the double fixed group were lower than those in the plate group,and the difference was statistically significant（P〈0.05）. The frac- ture healing time was （14.35±1.46） weeks in the double fixed group and （15.83±1.72） weeks in the plate group, and the fracture healing time in the double fixed group was significantly less than that of the plate group （P〉0.05）. The complication occurrence rate was 19.05 % in the double fixed group and 23.81% in the plate group,and there was no statistically significant difference between the two groups（P〉0.05）. The excellent and good rate of shoulder joint function in the double fixed group was 85.71%, which in the plate group was 71.43% ,and the difference was statistically significant （P〈0.05）. Conclusion Compared with the open reduction and plate internal fixation,minimally invasive hollow screw combined with suture anchor internal fixation in treating humeral fractures of greater tuberosity has the advantages of short operation time,less intraoperative bleeding volume,short fracture healing time and high excellent rate of shoulder joint function,which is worthy of popularization and application.