双钢板与单钢板内固定治疗肱骨近端骨折的临床研究

Comparison of the Efficacy and Safety of Double-Plate and Single-Plate Internal Fixationon Treatment of Fractures of the Proximal Humerus

目的:比较双钢板与单钢板内固定术式在肱骨近端NeerⅢ、Ⅳ型骨折中的应用效果及安全性。方法:选取2019年10月至2021年10月收治的80例肱骨近端NeerⅢ及Ⅳ型骨折患者,按照内固定方式将其分为双钢板组与单钢板组,每组各40例。双钢板组采用肱骨近端外侧锁定接骨板与内侧微型锁定钢板内固定,单钢板组采用肱骨近端外侧锁定接骨板内固定。比较两组临床相关指标,术后Neer评分、视觉模拟量表(VAS)评分、肩关节活动度以及并发症情况。结果:双钢板组手术时间、术中出血量明显大于单钢板组,差异有统计学意义(P<0.05),术后主动活动时间与骨折愈合时间明显小于单钢板组,差异有统计学意义(P<0.05);双钢板组治疗后Neer优良率、肩关节活动度均明显高于单钢板组,差异有统计学意义(P<0.05),VAS评分及并发症发生率明显低于单钢板组,差异有统计学意义(P<0.05)。结论:内外侧组合双钢板内固定术式在肱骨近端NeerⅢ、Ⅳ型骨折中的应用效果较单钢板更佳,更利于患者术后患肢关节功能恢复,治疗效果安全可靠。

Objective:To compare the application efficacy and safety of double-plate and single-plate internal fixation in the proximal humeral NeerⅢandⅣfractures.Methods:A total of 80 patients with NeerⅢandⅣfractures of the proximal humerus admitted to our hospital from October 2019 to October 2021 were selected and divided into double-plate group and single-plate group according to the internal fixation method with 40 cases in each group.Proximal humeral locking plate and medial micro locking plate were used for internal fixation in the double plate group,while the proximal lateral locking plate was used for internal fixation in the single plate group.The clinical related indexes,neer score,visual analogue scale(VAS),shoulder range of motion and complications were compared between the two groups.Results:The operation time and intraoperative blood loss in the double-plate group were significantly greater than those in the single-plate group(P<0.05),and the postoperative active activity time and fracture healing time were significantly shorter than those in the single-plate group(P<0.05).Neer excellent and good rate,shoulder joint range of motion of double plate-group were significantly higher than those of single plate-group after treatment(P<0.05),VAS score and incidence of complications were significantly lower than those of single plate group after treatment(P<0.05).Conclusion:The internal and lateral combined double-plate internal fixation method is more effective than single-plate in the proximal humeral NeerⅢandⅣfractures.It is more conducive to the recovery of postoperative joint function of the affected limb and the treatment efficacy is safe and reliable.