骨皮质解剖复位在肱骨近端骨折内固定术中内侧柱支撑重建的临床价值

Clinical value of anatomical reduction of cortex in reconstruction of medial column support during internal fixation of proximal humeral fracture

目的研究骨皮质解剖复位在肱骨近端骨折内固定术中内侧柱支撑重建的临床价值。方法选择我院43例肱骨近端骨折患者为研究对象,以随机数表法将其分为观察组(n=22)与对照组(n=21)。对照组行常规钢板内固定手术治疗,观察组在对照组基础上以骨皮质解剖复位重建内侧柱支撑。比较两组手术时间、骨折愈合时间、住院时间、完全负重时间、肩肘功能恢复情况、肱骨内翻角、并发症发生情况。结果观察组的骨折愈合时间、住院时间、完全负重时间均显著短于对照组,Neer、Broberg-Morrey评分均显著高于对照组,肱骨内翻角显著小于对照组,术后并发症总发生率显著低于对照组(P<0.05)。结论钢板内固定术治疗肱骨近端骨折时以骨皮质解剖复位重建内侧柱支撑可促进骨折愈合、肩肘功能恢复,降低术后并发症发生率。

Objective To study the clinical value of anatomical reduction of cortex in reconstruction of medial column support during internal fixation of proximal humeral fracture. Methods A total of 43 patients with proximal humerus fractures were selected as study objects. The patients were divided into observation group(n=22) and control group(n=21) according to the random number table method. The control group was treated with conventional plate internal fixation, while the observation group was reconstructed medial column support with cortical anatomical reduction on the basis of the control group. The operation time, fracture healing time, hospitalization time, total weight-bearing time, functional recovery of shoulder and elbow, humeral varus angle and complications were compared between the two groups. Results The fracture healing time, hospitalization time and total weight-bearing time of the observation group were significantly shorter than those of the control group, the scores of Neer and Broberg-Morrey were significantly higher than those of the control group, the humeral varus angle was significantly smaller than that of the control group, and the total incidence of postoperative complications was significantly lower than that of the control group(P<0.05). Conclusion The anatomical reduction of cortex in reconstruction of medial column support during internal fixation of proximal humeral fracture can promote fracture healing and functional recovery of shoulder and elbow, and reduce the incidence of postoperative complications.