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肱骨外科颈骨折两种手术方法治疗的临床分析(1)
http://www.100md.com 2010年6月5日 周树权
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     [摘要] 目的:探讨肱骨外科颈骨折行锁定加压钢板和三叶草型钢板内固定的疗效及价值。方法:将72例肱骨外科颈骨折患者随机分为锁定加压钢板组36例,三叶草型钢板内固定组36例。结果:采用锁定加压钢板内固定的患者,优19例,占52.78%,良15例,占41.67%,可2例,占5.56%,差0例,优良率为94.44%;三叶草型钢板内固定的患者,优15例,占44.67%,良14例,占38.89%,可5例,占13.89,差2例,占5.56%,优良率为80.56%,两组比较,差异有统计学意义(P<0.05)。结论:锁定加压钢板器固定较三叶草型钢板内固定有安全,固定牢靠,并发症少,骨折愈合快,能够早期功能锻炼及肩关节功能恢复良好等优点。

    [关键词] 肱骨外科颈骨折;锁定加压钢板;三叶草型钢板

    [中图分类号] R683.41 [文献标识码]A [文章编号]1674-4721(2010)06(a)-042-03

    Clinical analysis of two surgical treatments for humerus surgical neck fracture

    ZHOU Shuquan

    (Workers' Hospital of Wuzhou City, Guangxi Zhuang Autonomous Region, Wuzhou 543000,China)

    [Abstract] Objective:To discuss the efficacy value of humerus surgical neck fractures with locking compression plate and clover plate. Methods:The surgical neck of 72 patients with humerus fractures,and were randomly divided into locking compression plate group and the cloverleaf plate group, each group for 36 cases. Results:The patients were used locking compression plate fixation, 19 cases were excellent ,and the accounted was 52.78%; 15 cases were good, and the accounted was 41.67% , 2 cases for so-so ,and the accounted was 5.56%, and no case for bad, the good rate was 94.44%, patients treated by cloverleaf plate for 15 cases,and the accounted was 44.67%,14 cases were good,the accounted for 38.89%, accounting for 13.89 % in 5 cases and poor in 2 cases accounted for 5.56%, excellent rate was 80.56%,The difference was statistically significant(P<0.05). Conclusion:Locking compression plate for mounting over the safety clover plate and rigid fixation, fewer complications, fracture healing, to early exercise and the advantages of a good recover of shoulder function.

    [Key words] Humerus surgical neck fracture;Locking compression plate;Clover plate

    肱骨外科颈位于解剖颈下2~3 cm,即肱骨大结节之下,胸大肌止点之上,也就是肱骨干坚质骨与肱骨头松质骨交接处,最易发生骨折故名为外科颈骨折,此种骨折好发于中老年人[1]。肱骨外科颈骨折是一种常见的骨折,约占肩部骨折的23.3%。治疗分为非手术治疗和手术治疗两种方法,而手术治疗又分为经皮撬拨内固定、开放复位内固定、人工关节置换术等,其中内固定的材料又有针钉类、钢丝张力带类、解剖钢板类等[2],而目前手术治疗肱骨外科颈骨折的方法较多,但疗效不一。2007年2月~2010年1月,笔者采用锁定加压钢板和三叶草型钢板共治疗肱骨外科颈骨折72例,并对两种手术方法的治疗效果进行比较,现总结分析报道如下:

    1资料与方法

    1.1一般资料

    本组72例,男49例,女23例,年龄23~65岁,平均(42.50±3.77)岁,受伤部位:左侧34例,右侧38例。都属于闭合性骨折,根据X线片按Neer方法对骨折进行分类[3],32例为两部分骨折,30例为三部分骨折,10例为四部分骨折 ......

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