颈干角测量在肱骨近端骨折患者术后功能评价中的应用

Humeral neck-shaft angle measurement for the evaluation of postoperative function in patients with proximal humeral fractures

目的:分析颈干角测量在肱骨近端骨折患者术后功能评价中的应用。方法:选取2010年3月至2015年10月在广西医科大学第五附属医院接受切开复位锁定钢板内固定治疗的78例肱骨近端骨折患者。根据术后肱骨颈干角不同,将患者分为3组:内翻复位组(颈干角<127°,n=15)、正常复位组(颈干角127~145°,n=51)、外翻复位组(颈干角>145°,n=12)。比较3组骨折愈合时间、Constant-Murley肩关节功能评分、疼痛视觉模拟量表(VAS)评分及并发症发生率。结果:术后3组VAS评分及Constant-Murley肩关节功能评分比较,差异均无统计学意义(均P>0.05)。术后通过复查X线片,3组骨折愈合时间比较,差异无统计学意义(P>0.05)。内翻复位组的并发症发生率明显高于其他两组(P<0.05)。结论:颈干角在一定范围内增大或变小对肱骨近端骨折患者术后肩关节功能恢复及骨折愈合无明显影响。

Objective： To analyze the effect of humeral neck-shatt angle （NbA） measurement on tne evaiua tion of postoperative function in proximal humeral fractures patients. Methods： 78 patients with proximal humeral fractures undergoing open reduction and locking plate for internal fixation in our hospital from March 2010 to October 2015 were selected and divide into three groups according to different postoperative NSA： varus group in which the NSA was 〈127°, normal group in which the NSA was 127-145°, and val gus group in which the NSA was 〉145°. The fracture healing time, Constant-Murley shoulder joint score, visual analogue scale （VAS） score, and the incidence of complications were compared among the three groups. Results： The was no significant difference in VAS score, Constant Murley score and fracture hearling time among the three groups （P〉0.05）. The incidence of complications in varus group was higher than that in the other two groups （P〈0. 05）. Conclusion： Increase or decrease NSA within a certain range did not influence postoperative shoulder function recovery in patients with proximal humeral fractures.