经肩峰下前外侧入路微创内固定治疗肱骨近端骨折临床疗效分析

2020-12-31 07:27李月明
中外医疗 2020年31期
关键词:肱骨近端骨折内固定微创

李月明

[摘要] 目的 探究肱骨近端骨折采取經肩峰下前外侧入路微创内固定的治疗效果。方法 以随机法对2018年1月—2019年10月期间收治的52例肱骨近端骨折患者分成参照组(n=26)与试验组(n=26),参照组实施胸大肌三角肌间隙入路微创内固定治疗,试验组实施经肩峰下前外侧入路微创内固定治疗,对比两组患者术中出血量、手术操作时间、愈合时间、住院时间及并发症发生情况。结果 试验组患者术中出血量、手术操作时间、愈合时间、住院时间分别为(82.72±6.57)mL、(72.86±3.69)min、(3.16±0.12)月、(12.05±2.37)d均少于参照组的(106.81±8.92)mL、(96.37±4.38)min、(4.08±0.19)月、(20.94±3.29)d,差异有统计学意义(t=11.088、20.931、20.875、11.180,P<0.05),试验组患者并发症发生率为3.85%低于参照组的30.77%,差异有统计学意义(χ2=4.837,P<0.05)。结论 肱骨近端骨折采取经肩峰下前外侧入路微创内固定的治疗效果显著,能减少术中出血量,缩短住院及愈合时间,安全性较高。

[关键词] 内固定;微创;肱骨近端骨折;肩峰下前外侧入路

[中图分类号] R5          [文献标识码] A          [文章编号] 1674-0742(2020)11(a)-0016-03

Analysis of Clinical Efficacy of Minimally Invasive Internal Fixation via Subacromial Anterolateral Approach in the Treatment of Proximal Humeral Fractures

LI Yue-ming

Department of Orthopedics, Shanting District People's Hospital, Zaozhuang, Shandong Province, 277200 China

[Abstract] Objective To explore the effect of minimally invasive internal fixation for proximal humeral fractures through the subacromial anterolateral approach. Methods The 52 patients with proximal humeral fractures admitted from January 2018 to October 2019 were divided into a reference group (n=26) and a test group (n=26) by randomization. The reference group received the pectoralis major deltoid muscle Interstitial approach minimally invasive internal fixation, the experimental group received minimally invasive internal fixation through the subacromial anterolateral approach, and compared the two groups of patients' intraoperative blood loss, operation time, healing time, hospital stay and complications. Results The amount of blood loss, operation time, healing time, and hospitalization time of the test group were (82.72±6.57)mL,(72.86±3.69)min,(3.16±0.12)months,(12.05±2.37)d shorter than those of the reference group(106.81±8.92)mL,(96.37±4.38)min,(4.08±0.19)months,(20.94±3.29)d,the difference was statistically significant(t=11.088,20.931,20.875,11.180,P<0.05), the complication rate of the experimental group was 3.85% lower than that of the reference group 30.77%,the difference was statistically significant(χ2=4.837,P<0.05). Conclusion The treatment of proximal humeral fractures with minimally invasive internal fixation through the subacromial anterolateral approach can reduce intraoperative blood loss, shorten hospitalization and healing time, and is safer.

[Key words] Internal fixation; Minimally invasive; Proximal humeral fracture; Subacromial anterolateral approach

[2]  单辉强,李翀,邬亚明, 等.肩峰下外侧经三角肌入路微创经皮接骨板内固定技术结合PHILOS接骨板治疗肱骨近端骨折[J].中华骨与关节外科杂志,2016,9(5):418-420.

[3]  杨小海,徐锋,钱平康, 等.肩峰下微创入路治疗肱骨近端二部分、三部分骨折[J].中国血液流变学杂志,2017,27(1):72-73,104.

[4]  张笑,张鹏举,谢冰, 等.肩峰下横切口微创接骨板内固定治疗肱骨近端骨折的临床分析及手术技巧[J].中华骨与关节外科杂志,2016,9(1):49-52.

[5]  邓锋,郭英,王涛, 等.经皮微创钢板内固定术治疗肱骨近端骨折的疗效观察[J].科学养生,2019,22(10):257.

[6]  叶斌,王吟,叶正时.肱骨近端骨折运用微创钢板内固定结合肱骨近端锁定钢板治疗的观察[J].当代医学,2019,25(21):105-107.

[7]  钟洪波.经皮微创钢板内固定术治疗肱骨近端骨折的疗效观察[J].特别健康,2019(18):247.

[8]  谢明锐,唐诗添.微创锁定钢板内固定术治疗老年肱骨近端骨折患者的临床疗效分析[J].四川医学,2019,40(8):834-837.

[9]  王旭東.比较研究微创肱骨近端锁定钢板、传统固定术治疗肱骨近端骨折的实际价值[J].养生保健指南,2019,(47):247.

[10]  Qing-Feng Shen, Xin Wen, Sheng-Wu Yang. MIPPO and ORIF for the treatment of elderly proximal humerus fractures of type Neer II:a case control study[J].China Journal of Orthopaedics & Traumatology, 2018, 31(2):160-164.

[11]  Zadeh Hamid G, Somasundaram Karthikeyan, Babu Victor. Internal Fixation of 4-Part Proximal Humerus Fractures and Fracture Dislocations Using Extended Deltoid-splitting Approach, Locking Plates, and Calcium Sulfate Graft: Technical Details[J].Techniques in Shoulder & Elbow Surgery, 2018,19:129-137.

[12]  马永江,夏卫革,曾永新, 等.经肩峰下前外侧入路微创内固定治疗肱骨近端骨折临床疗效观察[J].实用手外科杂志,2019,33(3):266-268,278.

[13]  Shan Huiqiang, Li Yi, Tong Yaming, et al. Treatment of proximal humerus fractures with minimally invasive percutaneous osteosynthesis plate fixation combined with PHILOS osteosynthesis plate through the deltoid muscle approach to the sub lateral acromion[J].Chinese Journal of Bone and Joint Surgery, 2016,9(5): 418-420.

(收稿日期:2020-08-05)

猜你喜欢
肱骨近端骨折内固定微创
肱骨近端加压锁定钢板用于肱骨近端骨折治疗临床研究
内、外固定联合治疗不稳定性骨盆骨折疗效观察
锁定钢板结合抗骨质疏松药物治疗老年骨质疏松性肱骨近端骨折的疗效分析
跟骨骨折采用解剖型锁定钢板内固定治疗的效果分析
颈后路非融合寰枢椎内固定技术治疗Anderson Ⅲ型齿突骨折的临床研究
贲门失弛缓症的微创治疗进展
锁定钢板治疗肱骨近端骨折中肱骨颈干角重建对疗效影响的分析
锁定加压接骨板治疗肱骨近端骨折的临床分析
微创旋切术治疗182例下肢静脉曲张的术后护理
高速涡轮机、微创拔牙刀在阻生智齿拔除术中的应用观察