肱骨解剖型交锁髓内钉治疗肱骨近端骨折的临床观察
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徐州市中医院

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Clinical observation of anatomical interlocking intramedull- ary nail of humerus for displaced proximal humeral fractures
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Xuzhou City Hospital of Traditional Chinese Medicine

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    摘要:

    【摘要】目的 探讨肱骨解剖型交锁髓内钉治疗肱骨近端骨折(Neer 分型二部分、三部分)的疗效。方法 回顾分析 2016年08月至2018年4月本院创伤中心采用髓内钉治疗16例肱骨近段骨折患者,所有患者均获得完整随访。其中 Neer 分型二部分骨折11例,三部分骨折5例。分别详细记录患者手术时间、术中出血量和手术并发症,采用 Constant-Murley评分评估患侧肩关节功能。结果 随访时间最长18个月,最短8个月,平均随访时间为 12.35个月。手术时间最长105min,最短45min,平均手术时间62.74min。术中出血量最多220ml,最少80ml,平均出血量110.56ml。所有患者骨折都愈合,骨折平均愈合时间4.24个月,未见有肱骨头内翻畸形愈合。末次随访肩关节功能活动平均活动范围 : 内旋 33.33°、外旋50.71°、外展 130.24°、前屈 135.24°;肩关节VAS平均评分1.52分(1~10分);Constant-Murley 平均评分为 82.56 分,其中优 4 例、良 10、可 1 例、差 1 例,优良率为 87.5%。结论 采用肱骨解剖型交锁髓内钉治疗肱骨近端二部分、三部分骨折出血少、手术时间短、创伤小、固定牢固,术后可早期行功能锻炼,关节功能恢复良好,是治疗肱骨近端骨折的有效手段之一。

    Abstract:

    【Abstract】 Objective To explore the curative effect of anatomical interlocking intramedullary nail of humerus for displaced proximal humeral fractures (Neer 2-Part, 3-Part). Methods Retrospective analysis of 16 patients with proximal humerus fracture treated by intramedullary nail in the trauma center of Xuzhou City Hospital affiliated to Nanjing University of Traditional Chinese medicine from June 2016 to April 2018,and all patients were followed up completely.Among them, there were 11 cases of Neer classification 2-Part and 5 cases of Neer classification 3-Part .Detailly Recording operation time, intraoperative hemorrhage and surgical complications, and the lateral shoulder joint function was evaluated by Constant-murley score. Results Follow-up time of up to 20 months, minimum 8 months, average follow-up time of 12.35 months.The operation time is the longest 105min, the shortest 45min, the average operation time 62.74min.The amount of bleeding during operation is up to 220ml, at least 80ml, and the average amount of bleeding is 110.56ml.All patients with fractures healed, the average healing time of the fracture was 4.24 months, and no humerus head varus deformity healed.The average activity range of shoulder joint functional activity was internal spin 33.33°, external spin 50.71°, outreaching 130.24°, anterior flexor 135.24° in the last follow-up.Average shoulder VAS score was 1.52 points (1~10) in the last follow-up.The average score of the last follow-up Constant-murley was 82.56 points, of which Excellent 4 cases, Good 10 cases, General 1 Case and Poor 1 case, the excellent rate was 87.5%.Conclusions Using the anatomical interlocking intramedullary nail of humerus to treat the proximal humerus 2-part, 3-part of fracture bleeding less, short operation time, small trauma, fixed firmness, early functional exercise after operation, joint function recovery is good, which is one of the effective means to treat proximal humerus fracture.

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  • 收稿日期:2019-03-06
  • 最后修改日期:2019-04-04
  • 录用日期:2019-04-25
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