摘要
目的 分析肱骨近端骨折手术及非手术治疗方法的疗效。方法 肱骨近端骨折采用切开复位解剖钢板固定18例，手法复位肩肘固定带悬吊固定治疗23例；康复阶段采用加减海桐皮汤熏洗；采用Neer评分方法评定疗效。所有患者随访10—25个月，平均12个月。结果 采用切开复位解剖钢板固定Ⅱ型7例，优5例，良1例，可1例，优良率86％；手法复位Ⅱ型18例，优13例，良2例，可3例，优良率83％。切开复位解剖钢板固定Ⅲ型10例，优6例，良2例，可2例，优良率80％；手法复位Ⅲ型5例，优0例，良2例，可2例，失败1例，优良率40％。切开复位解剖钢板固定Ⅳ型1例，疗效评分尚可。NeerⅡ型骨折手术治疗与非手术治疗疗效相当（P〉0．05）；NeerⅢ型骨折手术疗效明显优于非手术疗效（P〈0．01）。X线片示无骨折不愈合及肱骨头坏死发生。结论 肱骨近端骨折NeerⅡ型尽可能采用非手术治疗，NeerⅢ、Ⅳ型采用解剖钢板固定疗效较好。
Objective To compare the curative effect between operative treatment and closed reduction of proximal humeral fractures. Methods 17 cases were treated with internal fixation with proximal humeral anatomic plate while 24 cases with closed reduction. The curative effect was evaluated according to Neer＇ s Score. All cases were followed up for 10 to 25 months. Results The effects of the surgical treatment with Neer＇ s Ⅱ fracture were excellent in 5 cases, good in 1, fair in 1, of the non-operation, excellent in 13, good in 2, and fair in 3. The percentage of fineness （excellent and good cases） was 86% and 83% ,respectively. In Neer＇ s Ⅲ fracture,the rate of fineness was 80% and 40% respectively. Only one case in Neer＇ s Ⅳ fracture with surgical treatment was fair. In comparision of curative effect, surgical treatment was superior to non-surgical treatment in Neer＇ s Ⅲ fracture（P 〈 0.01 ） ,but no significance existed in Neer＇ s Ⅱ fracture femoral head necrosis. Conclusion Surgical method is a satisfactory and effective technique in the treatment of Neer＇ s m and Ⅳ proximal humeral fracture. Closed reduction can achieve a good effect in treating Neer＇s Ⅱ fracture.
出处
《中国临床保健杂志》
CAS
2008年第4期392-394,共3页
Chinese Journal of Clinical Healthcare
关键词
肱骨骨折
骨折固定术
内
正骨疗法
熏洗
Humeral fractures
Fracture fixation, internal
Bone setting
Steaming washing thepapy
