锁定接骨板治疗累及肱骨距的肱骨近端骨折的效果

The Effect of Locking Bone Plate in the Treatment of Proximal Humeral Fractures Involving the Humeral Talar

目的研究锁定接骨板治疗累及肱骨距的肱骨近端骨折的临床效果。方法选取2017年5月~2020年5月我院接诊的98例累及肱骨距的肱骨近端骨折患者为研究对象,采用随机数字表法分为对照组和观察组,各49例。对照组采用常规切开复位内固定治疗,观察组采用锁定接骨板治疗,比较两组临床手术时间、术中出血量、骨折愈合时间、肱骨头高度丢失值、治疗疗效、肩关节功能(Constant-Mur1ey)评分、疼痛(VAS)评分以及并发症发生情况。结果观察组手术时间、术中出血量、骨折愈合时间、肱骨头高度丢失值均小于对照组,差异有统计学意义(P<0.05)。观察组临床治疗优良率为91.83%,高于对照组的81.63%,差异有统计学意义(P<0.05)。观察组Constant-Mur1ey各维度(疼痛、肌力、活动与日常生活、肩关节活动度)评分均高于对照组,差异有统计学意义(P<0.05)。观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为6.12%,低于对照组的14.28%,差异有统计学意义(P<0.05)。结论锁定接骨板治疗肱骨近端骨折累及肱骨距手术时间短,术中出血量少,对患者创伤小,可减小股骨头高度丢失,增强有效支撑,提高骨折愈合优良率,缩短骨折愈合时间,进而提高患者肩关节功能评分,且并发症发生几率小。

Objective To study the clinical effect of locking bone plates in the treatment of proximal humeral fractures involving the humeral talar.Methods A total of 98 patients with proximal humeral fractures involving the talar humerus who were admitted to our hospital from May 2017 to May 2020 were selected as the research objects.They were divided into a control group and an observation group using a random number table method,with 49 cases in each group.The control group was treated with conventional open reduction and internal fixation,and the observation group was treated with a locking bone plate.The clinical operation time,intraoperative blood loss,fracture healing time,humeral head height loss value,therapeutic effect,shoulder joint function(Constant-Murley)score,pain(VAS)score and complications were compared between the two groups.Results The operation time,intraoperative blood loss,fracture healing time,and loss of humeral head height in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).The clinical treatment excellent and good rate of the observation group was 91.83%,which was higher than 81.63%of the control group,the difference was statistically significant(P<0.05).The Constant-Murley scores of the observation group in all dimensions(pain,muscle strength,activity and daily life,shoulder joint mobility)were higher than those of the control group,the difference was statistically significant(P<0.05).The VAS score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 6.12%,which was lower than 14.28%in the control group,the difference was statistically significant(P<0.05).Conclusion Locking bone plate treatment of proximal humeral fractures involving the humeral talus has a short operative time,less intraoperative blood loss,and less trauma to the patient.It can reduce the height loss of the femoral head,enhance effective support,improve the rate of fracture healing,and shorten the healing time.This improves the patient's shoulder joint function score,and the incidence of complications is small.