加压锁定钢板治疗肱骨近端骨折的疗效分析

颜剑文

[摘要] 目的 探究與分析加压锁定钢板治疗肱骨近端骨折的临床疗效及其并发症发生情况。 方法 方便选取自2016年8月—2017年9月该院收治的肱骨近端骨折患者76例，采取随机数字表分为试验组和对照组，每组38例患者，试验组患者采用加压锁定钢板的方法进行治疗，对照组患者采用传统钢板进行治疗，观察并记录两组患者经不同方式治疗后术中出血量、手术、时间及术后引流量情况，记录两组患者发生螺钉松动、骨折不愈合及肩关节活动受限并发症情况，以及两组患者肩关节功能优良率情况。结果 试验组与对照组相比，两组患者术后引流量无明显差别，差异无统计学意义（t=2.204，P>0.05），试验组患者手术时间、术中出血量明显低于对照组，差异有统计学意义（t=3.204，4.201，P<0.05）。试验组患者螺钉松动、骨折不愈合、肩关节活动受限的发生率为0.00%、11.11%、0.00%，对照组发生率为5.26%、7.89%、15.78%，试验组明显优于对照组患者，差异有统计学意义（χ2 =3.816，3.654，4.012，P<0.05）。试验组患者Neer肩关节功能评价优良率为86.84%，对照组患者Neer肩关节功能评价优良率为78.95%，试验组明显高于对照组，差异有统计学意义（χ2=4.221，P<0.05）。结论 采用加压锁定钢板内固定的方法治疗肱骨近端骨折，可减少术中出血量，缩短手术时间，减少内螺钉松动、骨折不愈合以及肩关节活动受限的并发症的发生，减轻患者的痛苦，值得在临床上推广。

[关键词] 加压锁定钢板；传统钢板；肱骨近端骨折；临床疗效；并发症

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0082-03

Analysis of Curative Effect of Locking Compression Plate in Treatment of Fracture of Proximal End of Humerus

YAN Jian-wen

Department of Orthopedics， Fuzhou Second Hospital Affiliated to Xiamen University， Xiamen， Fujian Province， 350007 China

[Abstract] Objective To study and analyze the clinical curative effect and occurrence of complications of locking compression plate in treatment of fracture of proximal end of humerus. Methods 76 cases of patients with fracture of proximal end of humerus admitted and treated in our hospital from August 2016 to September 2017 were convenient selected and randomly divided into two groups with 38 cases in each， the test group were treated with locking compression plate， while the control group used the traditional plate， and the intraoperative bleeding amount， operation time and postoperative drainage volume of the two groups were recorded， and the excellent and good rate of shoulder joint function of the two groups were recorded. Results There was no obvious difference in the postoperative drainage volume between the two groups， and the difference was not obvious， without statistical significance（t=2.204，P>0.05） ， and the operation time and intraoperative bleeding amount in the test group were obviously lower than those in the control group， and the differences were statistically significant（t=3.204，4.201，P<0.05） ， and the incidence rate of adverse reactions in the test group was obviously better than that in the control group， （0.00%，11.11%，0.00% vs 5.26%，7.89%，15.78%）， and the difference was statistically significant（χ2=3.816，3.654，4.012，P<0.05）， and the excellent and good rate of Neer shoulder joint function in the test group was obviously higher than that in the control group （86.84% vs 78.95%）， and the difference was statistically significant（χ2=4.221，P<0.05）. Conclusion The locking compression plate in treatment of fracture of proximal end of humerus can reduce the intraoperative bleeding amount， shorten the operation time， and reduce the occurrence of complications such as loosening of internal screws， nonunion of fracture， and limitation of shoulder joint activity and relieve the pains of patients， and it is worth clinical promotion.

[Key words]Locking compression plate； Traditional plate； Fracture of proximal end of humerus； Clinical curative effect； Complication

肱骨近端骨折多由间接暴力导致，常见于中老年人，是比较常见的骨折类型，占所有骨折总数的4%左右[1-2]。随着我国人口逐步老龄化，肱骨近端骨折的发生率也逐渐增高。肱骨近端骨折一般分I、II、III、IV 4种类型，一般III、IV两种类型多采用手术治疗 [3-5]。该院此次采用加压锁定钢板以及传统钢板固定两种方法对该院2016年8月—2017年9月收治的76例肱骨近端骨折患者进行治疗，对比观察两种方法对此病的疗效及发生并发症情况，取得良好效果，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的76例肱骨近端骨折患……