?

經肩峰下前外側入路微創內固定治療肱骨近端骨折臨床療效分析

2020-12-31 07:27李月明
中外醫療 2020年31期
關鍵詞:肱骨近端骨折內固定微創

李月明

[摘要] 目的 探究肱骨近端骨折采取經肩峰下前外側入路微創內固定的治療效果。方法 以隨機法對2018年1月—2019年10月期間收治的52例肱骨近端骨折患者分成參照組(n=26)與試驗組(n=26),參照組實施胸大肌三角肌間隙入路微創內固定治療,試驗組實施經肩峰下前外側入路微創內固定治療,對比兩組患者術中出血量、手術操作時間、愈合時間、住院時間及并發癥發生情況。結果 試驗組患者術中出血量、手術操作時間、愈合時間、住院時間分別為(82.72±6.57)mL、(72.86±3.69)min、(3.16±0.12)月、(12.05±2.37)d均少于參照組的(106.81±8.92)mL、(96.37±4.38)min、(4.08±0.19)月、(20.94±3.29)d,差異有統計學意義(t=11.088、20.931、20.875、11.180,P<0.05),試驗組患者并發癥發生率為3.85%低于參照組的30.77%,差異有統計學意義(χ2=4.837,P<0.05)。結論 肱骨近端骨折采取經肩峰下前外側入路微創內固定的治療效果顯著,能減少術中出血量,縮短住院及愈合時間,安全性較高。

[關鍵詞] 內固定;微創;肱骨近端骨折;肩峰下前外側入路

[中圖分類號] R5 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 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] ?單輝強,李翀,鄔亞明, 等.肩峰下外側經三角肌入路微創經皮接骨板內固定技術結合PHILOS接骨板治療肱骨近端骨折[J].中華骨與關節外科雜志,2016,9(5):418-420.

[3] ?楊小海,徐鋒,錢平康, 等.肩峰下微創入路治療肱骨近端二部分、三部分骨折[J].中國血液流變學雜志,2017,27(1):72-73,104.

[4] ?張笑,張鵬舉,謝冰, 等.肩峰下橫切口微創接骨板內固定治療肱骨近端骨折的臨床分析及手術技巧[J].中華骨與關節外科雜志,2016,9(1):49-52.

[5] ?鄧鋒,郭英,王濤, 等.經皮微創鋼板內固定術治療肱骨近端骨折的療效觀察[J].科學養生,2019,22(10):257.

[6] ?葉斌,王吟,葉正時.肱骨近端骨折運用微創鋼板內固定結合肱骨近端鎖定鋼板治療的觀察[J].當代醫學,2019,25(21):105-107.

[7] ?鐘洪波.經皮微創鋼板內固定術治療肱骨近端骨折的療效觀察[J].特別健康,2019(18):247.

[8] ?謝明銳,唐詩添.微創鎖定鋼板內固定術治療老年肱骨近端骨折患者的臨床療效分析[J].四川醫學,2019,40(8):834-837.

[9] ?王旭東.比較研究微創肱骨近端鎖定鋼板、傳統固定術治療肱骨近端骨折的實際價值[J].養生保健指南,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] ?馬永江,夏衛革,曾永新, 等.經肩峰下前外側入路微創內固定治療肱骨近端骨折臨床療效觀察[J].實用手外科雜志,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)

猜你喜歡
肱骨近端骨折內固定微創
肱骨近端加壓鎖定鋼板用于肱骨近端骨折治療臨床研究
內、外固定聯合治療不穩定性骨盆骨折療效觀察
鎖定鋼板結合抗骨質疏松藥物治療老年骨質疏松性肱骨近端骨折的療效分析
跟骨骨折采用解剖型鎖定鋼板內固定治療的效果分析
頸后路非融合寰樞椎內固定技術治療Anderson Ⅲ型齒突骨折的臨床研究
賁門失弛緩癥的微創治療進展
鎖定鋼板治療肱骨近端骨折中肱骨頸干角重建對療效影響的分析
鎖定加壓接骨板治療肱骨近端骨折的臨床分析
微創旋切術治療182例下肢靜脈曲張的術后護理
高速渦輪機、微創拔牙刀在阻生智齒拔除術中的應用觀察
91香蕉高清国产线观看免费-97夜夜澡人人爽人人喊a-99久久久无码国产精品9-国产亚洲日韩欧美综合