新型加压钩板治疗肱骨大结节撕脱型骨折的临床疗效评价
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常州市武进中医医院

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常州市科技计划项目(项目编号:CJ20180003)


Clinical evaluation of a novel compression hook plate for the treatment of avulsion fracture of the humerus greater tuberosity
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Wujin affiliated Hospital of Nanjing University of Chinese Medicine

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    摘要:

    [目的] 比较新型加压钩板与PHILOS钢板治疗撕脱型肱骨大结节骨折的疗效。[方法] 回顾性分析 2016年2月~2017年12月本院收治并符合标准的 25 例撕脱型肱骨大结节骨折患者,按固定方式不同分为两组,新型加压钩板组12例,男7例,女5例,年龄26-64岁,平均44.1岁;PHILOS钢板组13例,男9例,女4例,年龄32-62岁,平均43.6岁。记录两组的切口长度、出血量、手术时间、并发症发生率以及骨折愈合时间。主要采用美国肩肘外科医师评分(ASES)及Constant-Murley评分系统(CMS)评价两组患者术后疗效。[结果]两组患者随访时间12-20个月,平均14.3个月。随访期间内新型加压钩板组无切口不良事件,神经血管损伤,骨折延迟愈合等并发症发生。两组在并发症发生率上无统计学差异(p>0.05)。加压钩板组在切口长度、术中出血量及手术时间方面均优于PHLIOS组,差异有统计学意义(p<0.05)。两组患者骨折愈合时间相当,无明显统计学差异(p>0.05)。末次随访时,新型加压钩板组患者的ASES及CMS评分均优于PHLIOS组,差异有统计学意义(p<0.05)。[结论] 与PHILOS钢板相比,新型加压钩板的优势在于可以减少创伤,术后肩关节功能康复更佳。

    Abstract:

    [Objective] To compare the efficacy of a new compression hook plate and PHILOS plate in the treatment of fractures of the humerus greater tuberosity. [Methods] A retrospective analysis of 25 patients with fractures of the humerus greater tuberosity who were admitted to our hospital from February 2016 to December 2017. the patients were divided into two groups according to different fixation methods. The new compression hook plate group consisted of 12 patients, 7 males and 5 females, aged 26-64 years, mean 44.1 years old; 13 patients in the PHILOS plate group, 9 males and 4 females, aged 32-62 years, mean 43.6 years old. The length of the incision, the amount of bleeding, the time of surgery, the incidence of complications, and the time to union were recorded. The postoperative outcomes of the two groups were evaluated primarily by the American Shoulder and Elbow Surgeon Score (ASES) and the Constant-Murley Scoring System (CMS). [Results] The follow-up time of the two groups was 12-20 months, with an average of 14.3 months. During the follow-up period, there was no incision adverse event, neurovascular injury, delayed fracture union and other complications in the new compression hook plate group. There was no significant difference in the incidence of complications between the two groups (p>0.05). The compression hook plate group was superior to the PHLIOS group in length of incision, intraoperative blood loss and operation time, and the difference was statistically significant (p<0.05). The fracture union time of the two groups was comparable, and there was no statistically significant difference (p>0.05). At the final follow-up, the ASES and CMS scores of the new compression hook plate group were better than those of the PHLIOS group, and the difference was statistically significant (p<0.05). [Conclusion] Compared with PHILOS plate, the new compression hook plate for the treatment of fractures of the humerus greater tuberosity has the advantages of small incision, less trauma, less postoperative complications and better recovery of shoulder function.

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  • 收稿日期:2019-01-24
  • 最后修改日期:2019-01-24
  • 录用日期:2019-03-26
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