桥接组合式内固定系统治疗肱骨干粉碎性骨折的临床效果分析
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摘要
目的分析桥接组合式内固定系统治疗肱骨干粉碎性骨折的临床效果。方法选取本院2015年6月至2018年6月收治的62例肱骨干粉碎性骨折患者为研究对象,按照随机数表法将其分为对照组(31例)和观察组(31例)。对照组患者采用钢板内固定治疗,观察组患者采用桥接组合式内固定系统治疗。比较两组患者临床疗效、手术相关指标、术后并发症发生率、术后6个月Mayo肘关节功能评分及Constant-Murley肩关节功能评分。结果观察组患者术中出血量显著少于对照组(P <0.05),住院天数、手术时间及骨折愈合时间均显著短于对照组(P_均<0.05),优良率显著高于对照组(P <0.05),术后并发症发生率显著低于对照组(P <0.05)。术后6个月,观察组患者Mayo肘关节功能和Constant-Murley肩关节功能各项评分及总分均显著高于对照组(P_均<0.05)。结论桥接组合式内固定系统治疗肱骨干粉碎性骨折,能够减少术中出血量,缩短手术时间和住院天数,促进骨折愈合,改善患者肩关节和肘关节功能,且术后并发症发生率较低,治疗效果良好。
Objective To investigate the clinical effect of bridge combine internal fixation system in the treatment of comminuted fracture of humeral shaft. Method From June 2015 to June 2018, 62 patients with comminuted fracture of humeral shaft were randomly divided into control group(n = 31) and observation group(n = 31), patients in control group were treated with steel plate internal fixation, and patients in observation group were treated with bridge combine internal fixation system, the clinical efficacy, operation-related indexes, incidence of postoperative complications, Mayo elbow function score and Constant-Murley shoulder function score 6 months after operation were compared between the two groups. Result The amount of intraoperative bleeding in observation group was significantly less than that in control group(P < 0.05), the days of hospitalization, operation time and fracture healing time were significantly shorter than those in control group(P_(all)< 0.05), the excellent and good rate was significantly higher than that in control group(P < 0.05), the incidence of postoperative complications was significantly lower than that in control group(P < 0.05). 6 months after operation, the total scores and each functional scores of Mayo elbow joint function and Constant-Murley shoulder joint function in observation group were significantly higher than those in control group(P_(all)< 0.05). Conclusion The treatment of humeral shaft comminute fracture with bridge combined internal fixation system can reduce the amount of intraoperative blood loss, shorten the time of operation and hospitalization, promote fracture healing, improve the function of shoulder and elbow joint, the incidence of postoperative complications is low, and the therapeutic effect is good.
Objective To investigate the clinical effect of bridge combine internal fixation system in the treatment of comminuted fracture of humeral shaft. Method From June 2015 to June 2018, 62 patients with comminuted fracture of humeral shaft were randomly divided into control group(n = 31) and observation group(n = 31), patients in control group were treated with steel plate internal fixation, and patients in observation group were treated with bridge combine internal fixation system, the clinical efficacy, operation-related indexes, incidence of postoperative complications, Mayo elbow function score and Constant-Murley shoulder function score 6 months after operation were compared between the two groups. Result The amount of intraoperative bleeding in observation group was significantly less than that in control group(P < 0.05), the days of hospitalization, operation time and fracture healing time were significantly shorter than those in control group(P_(all)< 0.05), the excellent and good rate was significantly higher than that in control group(P < 0.05), the incidence of postoperative complications was significantly lower than that in control group(P < 0.05). 6 months after operation, the total scores and each functional scores of Mayo elbow joint function and Constant-Murley shoulder joint function in observation group were significantly higher than those in control group(P_(all)< 0.05). Conclusion The treatment of humeral shaft comminute fracture with bridge combined internal fixation system can reduce the amount of intraoperative blood loss, shorten the time of operation and hospitalization, promote fracture healing, improve the function of shoulder and elbow joint, the incidence of postoperative complications is low, and the therapeutic effect is good.
引文
[1]李建斌,张仙梦,程喜红,等.应用MIPO技术治疗肱骨干粉碎性骨折患者的临床观察[J].齐齐哈尔医学院学报,2016,37(16):2076-2078.
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[4]张金东,马莉,苏凤娟,等.分步手法复位小夹板固定治疗肱骨干粉碎性骨折临床研究[J].亚太传统医药,2017,13(19):109-110.
[5]Ryu SM,Park JW,Moon JJ,et al.Computed tomography of bicondylar tibial plateau fractures after distraction with a bridging externalfixation[J].Int Orthop,2018,42(10):2451-2458.
[6]罗勇,徐相伟,范贵富,等.锁定加压钢板及顺行交锁髓内钉术式对肱骨干骨折患者的疗效及安全性的影响比较[J].国际医药卫生导报,2017,27(13):2039.
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[8]高泓一.自体髂骨移植结合锁定钢板内固定治疗肱骨近端粉碎性骨折的预后观察[J].现代诊断与治疗,2016,27(7):1181-1183.
[9]宋正鑫,杨东翔,刘岩,等.外侧入路MIPPO技术治疗肱骨干粉碎性骨折的疗效观察[J].实用骨科杂志,2016,22(5):390-392.
[10]郝迎新,陆晴友.肱骨干骨折的治疗现状[J].中国骨与关节损伤杂志,2018,33(3):331-333.
[11]李涛,王小健.逆行自锁髓内钉内固定治疗肱骨干骨折的临床效果评价[J].中国继续医学教育,2017,9(2):126-127.
[12]白晓东,邢更彦,姜川,等.解剖钢板内固定治疗复杂肱骨近端骨折伴肱骨干骨折[J].中华创伤杂志,2017,33(5):408.
[13]刘林,陆晴友,郝迎新,等.肱骨干骨折钢板内固定的入路选择与疗效分析[J].浙江临床医学,2017,19(4):627-629.
[14]梁伟,宫峰,黄力.有限切开锁定加压钛板内固定联合医用诱导骨基质植入治疗肱骨干粉碎性骨折[J].生物骨科材料与临床研究,2016,13(4):57-59.
[15]陈谷才,刘刚,刘进南,等.前侧入路微创钢板内固定技术治疗肱骨干中下段粉碎性骨折的临床分析[J].创伤外科杂志,2016,18(5):298-299.
[16]林知毅,黄培镇.顺行交锁髓内钉与锁定钢板内固定治疗肱骨干骨折疗效比较[J].中国骨与关节损伤杂志,2018,3(11):1136-1139.
[17]宋辉,贺韬,张超,等.长解剖钢板和髓内钉治疗肱骨近端骨折累及肱骨干骨折的疗效比较[J].临床骨科杂志,2018,21(4):96-99.
[18]何忠,李开静,王强,等.桥接组合式内固定系统治疗股骨干骨折术后骨不连的临床观察[J].中国现代医生,2017,55(9):91-93.
[19]何忠,李开静,王强,等.桥接组合式内固定系统治疗股骨干骨折术后钢板周围再骨折[J].中国骨与关节损伤杂志,2017,32(8):845-846.
[20]叶军,白龙,于志勇.桥接组合式内固定系统微创治疗肱骨干粉碎性骨折[J].实用骨科学,2016,22(10):921-924.
[2]Han SH,Hong IT,Lee HJ,et al.Primary exploration for radial nerve palsy associated with unstable closed humeral shaft fracture[J].Ulus Travma Acil Cerrahi Derg,2017,23(5):405-409.
[3]Lee HJ,Oh CW,Oh JK,et al.Minimally invasive plate osteosynthesis for humeral shaft fracture:a reproducible technique with the assistance of an external fixator[J].Arch Orthop Trauma Surg,2013,133(5):649-657.
[4]张金东,马莉,苏凤娟,等.分步手法复位小夹板固定治疗肱骨干粉碎性骨折临床研究[J].亚太传统医药,2017,13(19):109-110.
[5]Ryu SM,Park JW,Moon JJ,et al.Computed tomography of bicondylar tibial plateau fractures after distraction with a bridging externalfixation[J].Int Orthop,2018,42(10):2451-2458.
[6]罗勇,徐相伟,范贵富,等.锁定加压钢板及顺行交锁髓内钉术式对肱骨干骨折患者的疗效及安全性的影响比较[J].国际医药卫生导报,2017,27(13):2039.
[7]王亦璁.骨与关节损伤[M].北京:人民卫生出版社,2007:78-80.
[8]高泓一.自体髂骨移植结合锁定钢板内固定治疗肱骨近端粉碎性骨折的预后观察[J].现代诊断与治疗,2016,27(7):1181-1183.
[9]宋正鑫,杨东翔,刘岩,等.外侧入路MIPPO技术治疗肱骨干粉碎性骨折的疗效观察[J].实用骨科杂志,2016,22(5):390-392.
[10]郝迎新,陆晴友.肱骨干骨折的治疗现状[J].中国骨与关节损伤杂志,2018,33(3):331-333.
[11]李涛,王小健.逆行自锁髓内钉内固定治疗肱骨干骨折的临床效果评价[J].中国继续医学教育,2017,9(2):126-127.
[12]白晓东,邢更彦,姜川,等.解剖钢板内固定治疗复杂肱骨近端骨折伴肱骨干骨折[J].中华创伤杂志,2017,33(5):408.
[13]刘林,陆晴友,郝迎新,等.肱骨干骨折钢板内固定的入路选择与疗效分析[J].浙江临床医学,2017,19(4):627-629.
[14]梁伟,宫峰,黄力.有限切开锁定加压钛板内固定联合医用诱导骨基质植入治疗肱骨干粉碎性骨折[J].生物骨科材料与临床研究,2016,13(4):57-59.
[15]陈谷才,刘刚,刘进南,等.前侧入路微创钢板内固定技术治疗肱骨干中下段粉碎性骨折的临床分析[J].创伤外科杂志,2016,18(5):298-299.
[16]林知毅,黄培镇.顺行交锁髓内钉与锁定钢板内固定治疗肱骨干骨折疗效比较[J].中国骨与关节损伤杂志,2018,3(11):1136-1139.
[17]宋辉,贺韬,张超,等.长解剖钢板和髓内钉治疗肱骨近端骨折累及肱骨干骨折的疗效比较[J].临床骨科杂志,2018,21(4):96-99.
[18]何忠,李开静,王强,等.桥接组合式内固定系统治疗股骨干骨折术后骨不连的临床观察[J].中国现代医生,2017,55(9):91-93.
[19]何忠,李开静,王强,等.桥接组合式内固定系统治疗股骨干骨折术后钢板周围再骨折[J].中国骨与关节损伤杂志,2017,32(8):845-846.
[20]叶军,白龙,于志勇.桥接组合式内固定系统微创治疗肱骨干粉碎性骨折[J].实用骨科学,2016,22(10):921-924.