小切口经三角肌肌间隙入路微创固定治疗肱骨近端骨折的安全有效性分析

Safety and Effectiveness of Minimally Invasive Fixation via Deltoid Approach Through Small Incision in the Treatment of Proximal Humeral Fractures

目的探讨小切口经三角肌肌间隙入路微创固定治疗肱骨近端骨折的安全有效性。方法选取2018年1月至2019年10月江南大学附属医院骨科收治的44例肱骨近端骨折患者为研究对象,采用随机抽签的方式将患者分成两组实施研究,抽取到单数的患者纳为对照组,双数的患者纳入观察组,前者经三角肌胸大肌间隙入路微创固定治疗,后者小切口经三角肌肌间隙入路微创固定治疗,对比两组患者手术相关指标、肩关节功能评分情况及术后并发症情况。结果观察组手术用时、术后住院时间及骨折愈合时间较对照组显著缩短,术中失血量较对照组更少(P<0.05);观察组术后不同时间段肩关节功能评分显著优于对照组(P<0.05);观察组术后并发症发生率4.55%显著低于对照组术后并发症发生率27.27%,组间对比差异有统计学意义(P<0.05)。结论小切口经三角肌肌间隙入路微创固定治疗肱骨近端骨折可促进术后康复,缩短住院时间,预防并发症。

Objective To investigate the safety and effectiveness of minimally invasive fixation through deltoid muscle space approach in the treatment of proximal humeral fractures.Methods From January 2018 to October 2019,44 patients with proximal humerus fracture admitted to the Department of orthopedics,Affiliated Hospital of Jiangnan University,were selected as the research objects.The patients were randomly divided into two groups.The odd number and even number of patients were included in the control group and the observation group respectively.The former was treated by minimally invasive fixation through deltoid pectoralis major approach,and the latter through deltoid muscle space through small incision.The operation related indications,shoulder function score and postoperative complications of the two groups were compared.Results The operation time,postoperative hospital stay and fracture healing time of the observation group were significantly shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05);the shoulder joint function score of the observation group at different time points after operation was significantly better than that of the control group(P<0.05);the incidence of postoperative complications in the observation group and the control group were 4.55%and 27.27%,respectively,and the difference between the two groups was statistically significant(P<0.05).Conclusion Minimally invasive fixation through deltoid muscle space through small incision can promote postoperative rehabilitation,shorten hospital stay and prevent complications.