桥接组合式内固定系统治疗肱骨干下1/4骨折不愈合患者的临床效果

Clinical effect of combined internal fixation system with bridge in the treatment of nonunion of 1/4 fracture of humerus

目的分析探讨肱骨干下1/4骨折不愈合患者应用桥接组合式内固定系统治疗的临床效果。方法回顾性分析2009年1月~2015年1月在青海省人民医院骨科四病区就诊的112例肱骨干下1/4骨折不愈合患者的临床资料,根据采取治疗方案的不同将其分为对照组和观察组,每组各56例。对照组患者采用传统单锁定加压钢板治疗,观察组患者采用桥接组合式内固定系统治疗,比较两组患者治疗前后的生活质量评分、肘关节功能(Constant-Murley)评分及近期并发症发生情况。结果观察组患者治疗后的日常生活、社会活动、抑郁、烦躁、生活质量总评分及Constant-Murley评分明显高于对照组患者,差异有统计学意义(P <0.05);两组患者在术后1、3、6个月感染、血管神经损伤的发生得到有效控制,近期并发症的发生率比较,差异无统计学意义(P> 0.05)。结论应用桥接组合式内固定系统治疗肱骨干下1/4骨折不愈合可有效提高患者生存质量,关节功能复健良好,术后感染、血管神经损伤等并发症发生率低,临床效果显著。

Objective To analyze and discuss the clinical effect of the application of the bridge combined internal fixation system in the treatment of 1/4 fracture nonunion in the lower shaft of humerus.Methods Retrospective analysis was performed on the clinical data of 112 cases of fracture nonunion of the lower 1/4 of humerus from January 2009 to January 2015 in the Fourth Ward of Department of Orthopedics,Qinghai Provincial People′s Hospital.They were divided into control group and observation group with 56 cases in each group.A totol of 56 patients in the control group were treated with traditional single locking compression plate,and 56 patients in the observation group were treated with the bridge combined internal fixation system.The quality of life scores,elbow function scores(Constant-Murley)and recent complications of the two groups were compared before and after treatment.Results The observation group had significantly higher scores of daily life,social activities,depression,irritability,total quality of life and constant-murley after treatment than the control group(P<0.05).Infection and vascular and nerve injury were effectively controlled in the two groups at 1,3 and 6 months after surgery,and the incidence of recent complications was not statistically significant(P>0.05).Conclusion The application of the bridge combined internal fixation system in the treatment of the nonunion of 1/4 fracture of the lower shaft of the humerus can effectively improve the quality of life of the patients,the joint function rehabilitation is good,the incidence of postoperative complications such as infection,vascular and nerve injury is low,and the clinical effect is significant.