两种锚钉方式固定肱骨大结节骨折比较
DOI:
作者:
作者单位:

1.丹阳市人民医院骨科;2.东部战区总医院秦淮医疗区

作者简介:

通讯作者:

中图分类号:

基金项目:

国家自然科学基金青年科学基金项目(82102547),江苏省自然科学基金面上项目(BK20181113) .


A clinical analysis of single row anchor combined with bone tunnel and double row anchor in treatment of greater tuberosity fractures
Author:
Affiliation:

1.the People’S Hospital of Danyang;2.Qinhuai District Medical Area of Eastern Theater Command, PLA

Fund Project:

National Natural Science Foundation of China (NSFC), No. 82102547; The Natural Science Foundation of Jiangsu Province, No. BK20181113

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:比较单排锚钉联合骨隧道和双排锚钉技术在肱骨大结节骨折中的临床疗效。 方法:回顾性分析2017年06 月~2021年 06 月收治的44例肱骨大结节骨折患者,根据医患沟通结果后的手术方式不同分为单排-骨道组和双排锚钉组。比较两组患者围手术期、随访和影像资料。 结果:所有患者均获得骨性愈合,均未发生感染和内固定失败。两组患者手术时间、术中出血量、透视次数、主动活动时间、切口愈合时间、住院时间差异不明显(P均> 0. 05)。单排-骨道组切口长度为大于双排锚钉组,差异明显(P<0. 05)。单排-骨道组住院总费用低于双排锚钉组,差异显著(P<0. 05)。双排锚钉组有2例出现外排锚钉处松动性疼痛,单排-骨道组未出现。两组患者完全负重活动时间、骨折块移位、肩肱间隙和骨折愈合情况差异均无统计学意义(P均> 0. 05)。随着时间进展,两组患者的VAS评分、ASES评分、前屈上举活动度(ROM)、外展上举ROM和体侧外旋ROM较术前显著改善(P<0. 05),组间比较无明显差异(P>0.05)。 结论:单排锚钉联合骨隧道与双排锚钉固定治疗肱骨大结节骨折的临床疗效明确,均能有效提高肩关节功能、缓解术后疼痛并降低术后并发症及二次翻修手术,但单排锚钉联合骨隧道大大降低了医疗费用,且内固定松动率低。

    Abstract:

    Objective: To analyze the clinical effect of single row anchor combined with bone tunnel (SRA-BT) and double row anchor (DRA) in treatment of greater tuberosity fractures of humerus. Methods: A retrospective study was conducted on 44 patients with greater tuberosity fractures from June 2017 to June 2021, and they were divided into SRA-BT group and DRA group by different surgical methods after doctor-patient communication. Data regarding to perioperative period, follow-up and radiographs were compared between the two groups. Results: Bone healing was achieved in all patients without infection or internal fixation failure, and there were no significant differences in operation time, intraoperative blood loss, fluoroscopy times, active motion time, wound healing time, and hospital stay between the two groups (all p>0.05). The incision length of SRA-BT group was longer than that of DRA group (P< 0.05). The in-patient costs of SRA-BT group was significantly lower than that of DRA group (P<0. 05). 2 cases with pain at the outside anchor nail was occurred in DRA group, but not in SRA-BT group. There were no significant differences in the time of full weight-bearing activity, distance of fracture, acromiohumeral interval and bone healing between the two groups (all P > 0.05). As time went during the follow-up, the VAS score, ASES score, ROM of flexion, ROM of abduction and ROM of external rotation of the two groups were significantly improved compared with those before operation (P< 0.05), and there was no significant difference between the two groups (P>0.05). Conclusion: The clinical effect of technology of SRA-BT and DRA in the treatment of greater tuberosity fractures was clear. Both of them can effectively improve shoulder joint function, relieve postoperative pain and reduce postoperative complications and secondary revision surgery. However, the SRA-BT was significantly superior to DRA in terms of in-patient costs and internal fixation loosening.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2022-07-20
  • 最后修改日期:2022-10-15
  • 录用日期:2023-01-12
  • 在线发布日期:
  • 出版日期: