摘要
目的比较肱骨近端骨折术后上肢悬吊带固定与肩关节外展架外固定的效果。方法选取2017年1月至2019年8月江门市蓬江区中西医结合医院接诊的80例肱骨近端骨折患者作为研究对象,均顺利完成钢板内固定或者螺钉内固定手术治疗,按照随机数表法分为对照组和观察组,各40例。对照组术后接受上肢悬吊带固定治疗,观察组术后接受肩关节外展架外固定治疗,固定时间均为4~6周。比较两组患者术后6个月临床疗效、术前及术后6个月肩关节Neer评分、术后恢复情况(术后肩关节训练开始时间、骨折愈合时间、肱骨丢失高度、肱骨头内翻角)及并发症发生率。结果术后6个月,观察组优良率(95.00%)较对照组(77.50%)高(P<0.05)。术后6个月,两组Neer评分中疼痛、功能、运动范围、解剖分数及总分高于术前,且观察组Neer评分中疼痛、功能、运动范围、解剖分数及总分高于对照组(P<0.05)。观察组术后肩关节训练开始时间、骨折愈合时间短于对照组,肱骨丢失高度、肱骨头内翻角小于对照组(P<0.05)。观察组并发症发生率(2.50%)较对照组(15.00%)低(P<0.05)。结论与上肢悬吊带固定相比,对肱骨近端骨折患者术后应用肩关节外展架外固定效果更加显著,患者可早期接受功能锻炼,有助于促进骨折愈合及肩关节功能康复,减少并发症发生率,值得应用推广。
Objective To compare the effect of upper limb sling fixation and shoulder joint abduction frame external fixation after operation on proximal humerus fracture.Methods A total of 80 patients with proximal humeral fracture who received therapy from January 2017 to August 2019 in Jiangmen Pengjiang Integrated Traditional Chinese and Western Medicine Hospital were selected as the research objects,and they were successfully treated with the operation of plate internal fixation or screw internal fixation.According to the random number table,they were divided into control group and observation group,and each group had 40 cases.Control group was treated with upper limb sling fixation after operation,and observation group was treated with external fixation with shoulder abduction frame after operation.The fixed time was 4 to 6 weeks.The clinical effect at 6 months after operation,shoulder joint Neer score before and 6 months after operation,recovery after operation(the start time of postoperative shoulder joint training,healing time of fracture,the humeral loss height,humeral head varus angle)and incidence of complications were compared between the two groups.Results After 6 months after operation,the excellent and good rate(95.00%)of observation group was higher than that(77.50%)of control group(P<0.05).After 6 months after operation,the pain,function,range of motion,anatomic score and total score of Neer score in the two groups were higher than those before operation,and the pain,function,range of motion,anatomic score and total score of Neer score in observation group were higher than those in control group(P<0.05).The start time of postoperative shoulder joint training,healing time of fracture in observation group were shorter than those in control group,the humeral loss height and humeral head varus angle were smaller than those in control group(P<0.05).The incidence of complication(2.50%)in observation group was lower than that(15.00%)in control group(P<0.05).Conclusion Compared with the upper limb sling fixation,the external fixation with shoulder abduction frame is more effective after the operation of proximal humerus fracture.Patients can receive early functional exercise,which is more helpful to promote fracture healing and shoulder joint function recovery and reduce the incidence of complications.It is worth popularizing.
作者
陈玉成
黄志伟
林作华
罗慧钦
何炳旋
CHEN Yu-cheng;HUANG Zhi-wei;LIN Zuo-hua;LUO Hui-qin;HE Bing-xuan(Department of Orthopedics Two District,Jiangmen Pengjiang Integrated Traditional Chinese and Western Medicine Hospital,Jiangmen 529000,Chin;Department of Orthopedics Five District,Jiangmen Pengjiang Integrated Traditional Chinese and Western Medicine Hospital,Jiangmen 529000,Chin;TCM Bone-Setting,Jiangmen Pengjiang Integrated Traditional Chinese and Western Medicine Hospital,Jiangmen 529000,Chin;Department of Orthopedics Three District,Jiangmen Pengjiang Integrated Traditional Chinese and Western Medicine Hospital,Jiangmen 529000,China)
出处
《河南医学研究》
CAS
2020年第31期5795-5798,共4页
Henan Medical Research
关键词
肱骨近端骨折
上肢悬吊带
肩关节外展架外固定
肩关节功能
康复效果
并发症
proximal humeral fracture
upper limb sling
shoulder joint abduction frame external fixation
shoulder joint function
rehabilitation effect
complication
