经三角肌外侧纵行分开入路锁定钢板内固定治疗肱骨近端骨折的效果观察

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摘要目的探讨经三角肌外侧纵行分开入路锁定钢板内固定治疗肱骨近端骨折的效果。方法选取2011年3月～2016年5月我院收治的65例肱骨近端骨折患者作为研究对象，按手术入路的不同分为治疗组（32例）和常规组（33例）。治疗组采用经三角肌外侧纵行分开入路锁定钢板内固定术，常规组患者采用经胸大肌-三角肌间隙入路锁定钢板内固定术。观察两组患者的术中出血量、手术时间、骨折愈合时间、手术并发症，并比较术后3个月两组患者的 Constant评分。结果治疗组和常规组患者的术中出血量[（90.2±29.9）、（240.1±64.9）ml]、骨折愈合时间[（79.9±1.7）、（91.0±2.2）d]比较，差异有统计学意义（P＜0.05），治疗组患者的手术时间[（71.9±14.9）min]与常规组[（69.8±15.7）min]比较，差异无统计学意义（P＞0.05）。治疗组患者术后并发症的发生率（6.3%）低于常规组（15.2%），差异有统计学意义（χ2=3.85，P＜0.05）。治疗组患者术后 3 个月的 Constant评分[（85.1±6.9）分]优于常规组[（74.9±7.0）分]，差异有统计学意义（P＜0.05）。结论经三角肌外侧纵行分开入路治疗肱骨近端骨折，具有术中出血量小、骨折愈合时间短、肩关节功能早期恢复较好及术后并发症少等优点，值得临床推广。

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	郭文龙

关键词 ：经三角肌外侧纵行分开入路, 经胸大肌-三角肌间隙入路, 肱骨近端骨折, 锁定钢板内固定

Abstract：ObjectiveTo explore the efficacy of locking plate fixation with deltoid lateral separate approach in the treatment of proximal humeral fractures.Methods65 cases with proximal humerus fracture treated in our hospital from March 2011 to May 2016 were selected as the subjects,and divided into the observation group(32 cases)and control group(33 cases)according to the different operative approaches.The patients in the observation group were treated with locking plate fixation by dehopectoral approach,and the patients in the control group were treated with locking plate fixation by lateral deltoid approach approach.The intraoperative blood loss,operation time,fracture healing time,postoperative complication rate,Constant scores of shoulder function at different times after operation were observed in two groups.ResultsThe intraoperative blood loss of the observation group was(90.2±29.9)ml,and the control group was(240.1±64.9)ml.The fracture healing time of two groups was([79.9±1.7]、[91.0±2.2]d).The difference between the two groups was statistically significant(P＜0.05).There was no significant difference between the observation group([71.9±14.9]min)and the control group ([69.8±15.7]min)in the operation time(P＞0.05).The incidence of postoperative complications in the observation group(6.3%)was lower than that in the control group(15.2%),the difference was statistically significant(P＜0.05).Constant scores in the observation group were better than those in the control group at 3 months after operation,the difference was statistically significant(P＜0.05).ConclusionThe lateral deltoid approach with locking plate fixation has advantages with dehopectoral approach in treatment of proximal humeral fractures,less intraoperative bleeding,shorter fracture healing time,faster recovery of shoulder function and less postoperative complications,which is worth a wide application.

Key words： Deltoid lateral separate approach Dehopectoral approach Proximal humeral fractures Locking plate fixation

引用本文:

郭文龙. 经三角肌外侧纵行分开入路锁定钢板内固定治疗肱骨近端骨折的效果观察[J]. 中国当代医药, 2018, 25(4): 97-99.
GUO Wen-long. The clinical efficacy of locking plate fixation with deltoid lateral separate approach in the treatment of proximal humeral fractures. 中国当代医药, 2018, 25(4): 97-99.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I4/97

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