Multiloc肱骨髓内钉系统治疗成人肱骨近端骨折的效果

Effect of Multiloc Humeral Intramedullary Nail System in the Treatment of Adult Proximal Humerus Fractures

目的:探讨Multiloc肱骨髓内钉系统(简称“M系统”)治疗成人肱骨近端骨折(PHF)的效果。方法:选择2019年6月—2021年6月漳州市第三医院收治的108例成人PHF患者作为观察对象,按便利抽样法分为C组和O组,各54例。C组实施肱骨近端锁定内固定系统(PHILOS),O组实施M系统治疗。对比两组的手术相关指标、肱骨颈干角、肩关节活动度、疼痛、并发症情况。结果:O组术中出血量少于C组,手术、骨折愈合、住院时间均短于C组(P<0.05)。术后3、6个月,O组的肱骨颈干角大于C组,肩关节中立位外旋、前屈、外展的活动度均大于C组(P<0.05)。术后3、6个月,两组的视觉模拟评分法(VAS)评分均较术前降低(P<0.05),但组间比较,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:髓内钉系统和M系统均能有效治疗成人肱骨近端二、三部分骨折,且术后并发症少、疼痛轻,而M系统的优势在于可有效减少术中出血,缩短术后住院时间和骨愈合时间,并有效减少肱骨颈干角丢失,利于患者肩关节活动功能的恢复。

Objective:To investigate the effect of Multiloc humeral intramedullary nail system("M system"for short)in the treatment of adult proximal humerus fracture(PHF).Method:A total of 108 adult PHF patients admitted to the Third Hospital of Zhangzhou City from June 2019 to June 2021 were selected as observation objects,and were divided into group C and group O according to convenience sampling method,with 54 cases in each group.The proximal humeral internal locking system(PHILOS)was used in group C,and M system was used in group O.The operation related indexes,humeral neck shaft angle,shoulder joint range of motion,pain and complications were compared between the two groups.Result:The amount of intraoperative bleeding in group O was less than that in group C,and the operation,fracture healing and hospital stay time were shorter than those in group C(P<0.05).At 3 and 6 months after operation,the humeral neck shaft angle in group O was greater than that in group C,and the range of motion of shoulder neutral external rotation,forward flexion and abduction were greater than those in group C(P<0.05).At 3 and 6 months after operation,the scores of visual analogue scale(VAS)in the two groups were lower than those before operation(P<0.05),but there were no significant differences between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Both the intramedullary nail system and the M system can effectively treat the second and third part PHF in adults with less complications and less pain.The advantage of the M system is that it can effectively reduce intraoperative bleeding and shorten the postoperative hospital stay and bone healing time,and effectively reduce the loss of humeral neck shaft angle,which is beneficial to the recovery of shoulder joint function.