可膨胀髓内钉治疗肱骨干骨折的近远期疗效观察

The short-term and long-term effect of expandable intramedullary nail on the treatment of humeral shaft fracture

目的观察可膨胀髓内钉(Expandable Intramedullary Nail, EIMN)治疗肱骨干骨折的近远期疗效。方法选取2015年5月-2017年5月收治的60例肱骨干骨折患者作为研究对象。采用简单随机分组法分为观察组(n=30)和对照组(n=30),观察组采用EIMN治疗,对照组采用锁定加压钢板(Locking Compression Plate, LCP)治疗,术后随访3年。比较两组手术出血量、手术时间、住院时间、骨折愈合时间、Constant肩关节功能评分、Mayo肘关节功能评分和术后并发症。结果观察组的手术出血量、手术时间、骨折愈合时间均低于对照组(P <0.05);术后6个月,观察组Constant肩关节功能评分低于对照组(P <0.05),Mayo肘关节功能评分高于对照组(P <0.05),两组患肢评分均低于术前健肢(P <0.05);术后3年,两组患肢评分差异无统计学意义(P>0.05),与术前健肢相比评分差异无统计学意义(P>0.05);观察组并发症发生率为10.00%,低于对照组33.33%(P <0.05)。结论 EIMN治疗肱骨干骨折的疗效显著,且手术出血量和并发症少,手术时间和骨折愈合时间短。

Objective To observe the short-term and long-term effects of expandable intramedullary nail(EIMN)on the treatment of humeral shaft fracture.Methods A total of 60 patients with humeral shaft fracture were selected from May 2015 to May 2017.The subjects were divided into two groups:Observation Group(n=30)and Control Group(n=30).The observation group was treated with Eimn and the control group was treated with locking compression plate(LCP).The operative blood loss,operative time,hospital stay,fracture healing time,Constant shoulder function score,Mayo elbow function score and postoperative complications were compared between two groups.Results The blood loss,operation time and fracture healing time of the observation group were lower than those of the control group(P<0.05)and the Constant shoulder function score of the observation group was lower than that of the control group(P<0.05)6 months after operation,the score of elbow function in Mayo Group was higher than that in control group(P<0.05)and the score of the affected limb in both groups was lower than that of the healthy limb before operation(P<0.05).There was no significant difference between two groups three years after operation(P<0.05),there was no significant difference between two groups(P>0.05)and the complication rate of the observation group was 10.00%,which was lower than that of the control group(33.33%,P<0.05).Conclusion EIMN is effective in the treatment of humeral shaft fracture with less operative bleeding and complications,and shorter operative time and fracture healing time.