| 锁定钢板与髓内钉治疗肱骨近端Neer Ⅲ、Ⅳ部分骨折的临床对比研究 |
| 投稿时间：2015-08-29 修订日期：2015-09-29 点此下载全文 |
| 引用本文：程刚,陶占怀,张博,焦耿君.锁定钢板与髓内钉治疗肱骨近端Neer Ⅲ、Ⅳ部分骨折的临床对比研究[J].医学研究杂志,2016,45(7):108-112 |
| DOI：
10.11969/j.issn.1673-548X.2016.07.029 |
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| 中文摘要:目的 对比锁定钢板与髓内钉治疗复杂肱骨近端骨折的效果。方法 回顾分析2008年3月～2014年3月采用锁定钢板或髓内钉治疗，并获得半年以上回访的Neer分型3部分和4部分肱骨近端骨折患者，对比两组患者的手术用时、切口长度、颈干角、疼痛评分、Constant功能评分、上臂前举角度、并发症等指标。结果 无论Neer分型3部分或4部分骨折，髓内钉组在手术用时、术中出血量、切口长度上，均明显优于锁定钢板组（P<0.01），两组患者在术后疼痛评分、颈干角、骨折愈合时间方面差异无统计学意义（P >0.05）；Neer分型3部分骨折患者，锁定钢板组与髓内钉组Constant评分（87.4±10.4，85.2±13.5）及前举角度（152.7°±25.3°，148.9°±21.70°）差异均无统计学意义（P >0.05）；而对于4部分骨折患者，髓内钉组的Constant评分（74.6±11.4）及前举角度（127.0°±22.4°），显著低于锁定钢板组（82.1±7.5，141.7°±12.7°）。结论 两种方法治疗复杂肱骨近端骨折均可获得较好效果，髓内钉创伤小，手术时间短，锁定钢板术后肩关节功能恢复较好。 |
| 中文关键词:肱骨近端骨折|锁定钢板|髓内钉 |
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| Comparative Study of Locking Plate and Intramedullary Nail in Treatment of Neer Ⅲ,Ⅳ Proximal Humerus Fracture |
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| Abstract:Objective To compare the effects of the locking plate and intramedullary nail for the treatment of complex humerus complicated fractures. Methods The patients whose three or four parts fractures treated by the locking plate or intramedullary nail and followed up for more than half a year from March 2008 to March 2014 were analyzed retrospectively. The surgical duration, intraoperative blood loss, length of cut, collodiaphysial angle, visual analogue score, Constant-Murley score, forward angle of forearms and complications were compared between the two groups. Results Both the three and four parts patients, the surgical duration and length of cut were shorter (P<0.01). While the VAS, collodiaphysial angle and fracture healing time were similar between two groups (P >0.05). For the patients with three parts fractures, there was no significant difference in the Constant score (87.4±10.4, 85.2±13.5)and forward angle (152.7°±25.3°, 148.9°±21.7°) between the two groups, but for the patients with four parts fractures, the Constant score (74.6±11.4) and forward angle (127.0°±22.4°) was worse in the intramedullary nail group compared to the plate group (82.1±7.5, 141.7°±12.7°). Conclusion Two kinds of methods for treatment of complex fractures of the proximal humerus can obtain better effect. Intramedullary nail had aspects of less trauma, short operation time, while locking plate had better shoulder joint function recovery. |
| keywords:Proximal humerus fractures|Locking plate|Intramedullary nail |
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