| 组合式外固定架与钢板固定治疗肱骨投掷骨折的比较研究 |
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Received:November 14, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 高培刚 |
GAO Pei-gang |
解放军中部战区空军医院骨科, 山西 大同 037006 |
Department of Orthopaedics, Air Force Hospital of PLA Central Theater Command, Datong 037006, Shanxi, China |
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| 王兴存 |
WANG Xing-cun |
解放军中部战区空军医院骨科, 山西 大同 037006 |
Department of Orthopaedics, Air Force Hospital of PLA Central Theater Command, Datong 037006, Shanxi, China |
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| 朱立强 |
ZHU Li-qiang |
解放军中部战区空军医院骨科, 山西 大同 037006 |
Department of Orthopaedics, Air Force Hospital of PLA Central Theater Command, Datong 037006, Shanxi, China |
sxdtzlq322@foxmail.com |
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| 期刊信息：《中国骨伤》2025年38卷，第6期，第613-618页 |
| DOI：10.12200/j.issn.1003-0034.20240349 |
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目的：比较组合式外固定架与钢板固定治疗肱骨投掷骨折的临床疗效。
方法：回顾性分析2018年2月至2021年2月收治的67例男性肱骨投掷骨折患者,根据治疗方法不同分为外固定架组和钢板组。外固定架组32例,年龄18~27(23.6±2.6)岁;AO分型,A型19例,B型13例;采用组合式外固定架固定。钢板组35例,年龄17~28(23.2±2.9)岁;AO分型,A型21例,B型14例;采用钢板螺钉固定。比较两组手术时间、术中出血量、切口长度、骨折愈合时间和并发症情况。术后12个月采用Mayo肘关节功能评分(Mayo elbow performance score,MEPS)及Neer肩关节功能评分进行临床疗效评价。
结果：两组患者顺利完成手术,术后均获得随访,时间15~21(18.3±3.4)个月。外固定架组术中出血量、切口长度、骨折愈合时间及术后12个月MEPS分别为(68.5±15.7) ml、(4.9±1.2) cm、(10.5±2.9)周、(93.6±5.1)分,优于钢板定组(149.4±38.9) ml、(12.5±2.4) cm、(12.8±2.7)周、(85.6±6.8)分,差异均有统计学意义(P<0.05);两组手术时间、术后12个月Neer肩关节功能评分比较,差异均无统计学意义(P>0.05)。钢板组6例桡神经损伤,外固定架组无桡神经损伤病例,两组比较差异有统计学意义(χ2=6.025,P<0.05)。术后12个月,MEPS分级、Neer肩关节功能评分分级比较差异均无统计学意义(P>0.05)。两组患者均达到骨性愈合,无内固定失败病例。
结论：组合式外固定架治疗肱骨投掷骨折,具有术中桡神经损伤发生率低、出血少、并发症少、骨折愈合快等特点,骨折愈合后方便取出。 |
| [关键词]:肱骨投掷骨折 外固定架 钢板 骨折固定术,内 |
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| Comparative study of combined external fixator and plate fixation in the treatment of humerus throwing fracture |
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Abstract:
Objective To compare clinical efficacy of combined external fixator and plate fixation in treating throwing fracture of humerus.
Methods Sixty-seven male patients with throwing humerus fracture admitted from February 2018 to February 2021 were retrospectively analyzed and divided into external fixator group and plate group according to different treatment methods. There were 32 patients in external fixator group,aged from 18 to 27 years old with an average of (23.6±2.6) years old;19 patients with type A,13 patients with type B according to AO classification;fixed by combined external fixer. There were 35 patients in plate group,aged from 17 to 28 years old with an average of (23.2±2.9) years old;21 patients with type A,14 patients with type B according to AO classification;fixed with steel plate screws. Operation time,intraoperative blood loss,total incision length,fracture healing time and complications were compared between two groups. Clinical effect was evaluated by Mayo elbow performance score (MEPS) and shoulder Neer score at 12 months after operation.
Results Patients in both groups were successfully completed operation and followed up for 15 to 21 months with an average of (18.3±3.4) months. In external fixator group,intraoperative blood loss,incision length,fracture healing time and postoperative MEPS of elbow joint function at 12 months were (68.5±15.7) ml,(4.9±1.2) cm,(10.5±2.9) weeks,(93.6±5.1) min,respectively;which were superior to ml (149.4±38.9) ml,(12.5±2.4) cm,(12.8±2.7) weeks,(85.6±6.8) in plate group (P<0.05),and had significant differences;there were no significant difference in operative time and postoperative Neer score of shoulder joint function at 12 months between two groups (P>0.05). There were 6 patients occurred radial nerve injury in plate group and no patient occurred radial nerve injury in external fixator group,and the difference between two groups was statistically significant (χ2=6.025,P<0.05). There were no significant difference in postoperative MEPS grading and Neer shoulder joint grading at 12 months (P>0.05). Bone healing was achieved in both groups without failure of internal fixation.
Conclusion The combined external fixator for the treatment of humerus throwing fracture has characteristics of low incidence of radial nerve injury,less bleeding,less complications,fast fracture healing,which is convenient to remove after fracture healing. |
| KEYWORDS:Throw fracture humerus External bracket Steel plates Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 高培刚,王兴存,朱立强.组合式外固定架与钢板固定治疗肱骨投掷骨折的比较研究[J].中国骨伤,2025,38(6):613~618 |
| 英文格式: | GAO Pei-gang,WANG Xing-cun,ZHU Li-qiang.Comparative study of combined external fixator and plate fixation in the treatment of humerus throwing fracture[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(6):613~618 |
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