杨氏骨科手法加小夹板非手术治疗老年Neer3、4型肱骨近端骨折120例临床观察

Clinical Observation of Applying YANG's Orthopedic Manipulation Combined with Small Splint in the Treatment of 120 Cases of Elderly Neer 3,4 Proximal Humeral Fractures/

目的:观察杨氏骨科手法加小夹板非手术治疗Neer3型老年肱骨外科颈骨折的疗效的影响。方法:收集分析了成都骨科医院2015年1月~2018年12月120例老年肱骨外科颈骨折患者的临床资料,其中男性52例,女性68例年龄60~84岁,平均72岁。骨折按照NEER分型[1]:三部骨折96例,四部骨折24例。其中杨氏骨科手法加小夹板非手术治疗肱骨外科颈骨折60例(A组),锁定钢板手术治疗肱骨外科颈骨折(B组)。比较两组患者在肩关节恢.复情况的不同。结果:两组病例均得到6~12个月的随访,平均随访8个月。两组病例的肩关节外展活动度差异有统计学意义(P<0.01);肩关节曲屈、伸展、外旋、内旋、Constant--Murley肩关节评分差异无统计学意义(P>0.05)。结论:两种方式治疗肱骨外科颈骨折均能获得肯定的疗效。

Objective:To observe the effect of YANG’s orthopaedic manipulation combined with small splints on the treatment of Neer 3 type elderly humeral surgical neck fracture.Methods:The clinical data of 120 elderly patients with humeral surgical neck fracture from January 2015 to December 2018 in Chengdu Orthopaedic Hospital were collected and analyzed,including 52 males and 68 females aged 60 to 84 years,with an average age of 72 years.According to NEER classification,there were 96 cases of three fractures and 24 cases of four fractures.Among them,60 cases(group A) of humeral surgical neck fracture were treated by YANG’s orthopaedic manipulation combined with small splint,and 60 cases(group B) of humeral surgical neck fracture were treated by operation.The difference of shoulder joint recovery between the two groups was compared.Results:The two groups were followed up for 6 months to 12 months,with an average of 8 months.There was no significant difference in shoulder flexion,extension,external rotation,internal rotation and Constant-Murley shoulder score between the two groups(P>0.05).Conclusion:Both methods can obtain definite curative effect in the treatment of humeral surgical neck fracture.