肱骨干骨折微创钢板固定与带锁髓内针固定术临床疗效比较

摘要

Objective:To compare the treatment of intramedullary nail fixation and minimally invasive plate fixation of humeral shaft fractures in clinical effect.Method:70 patients with humeral shaft fractures treated in our hospital from August 2011 to January 2013 were divided into the observation group(n=38)and the control group(n=32)according to random number table method. The observation group was treated with intramedullary nail fixation treatment,the control group was treated with minimally invasive plate fixation,the two groups were recorded operative time,blood loss,complications, fracture healing time,rate of fracture healing,shoulder function score,and evaluated the effect of different fixation methods.Result:The operation time was(94±30)min,blood loss was(76±51)mL in the observation group;the control group were(126±37)min and(138±57)mL,the observation group’ operative time and blood loss were significantly less than the control group(P<0.05).The observation group’ fracture healing time was(10.27±1.76) weeks and shoulder function score was(97 ± 5)scores,the control group were(10.45±2.22)weeks,(95±6)scores,the two groups in fracture healing time and shoulder function score were not statistically significant(P>0.05). The complication rate of the observation group was 15.8%,the control group’ complication rate was 21.9%,the two groups had no statistically significant(P>0.05).Conclusion:Minimally invasive plate fixation compared with humeral shaft fracture,although the treatment of intramedullary nailing in fracture healing time and shoulder function score no significant difference,but it can effectively shorten the operation time,reduce blood loss,and reduce the incidence of complications,it is worth in the clinical symptoms of the patient, a reasonable choice.%目的：比较带锁髓内针固定治疗和微创钢板固定治疗在肱骨干骨折治疗中的临床效果。方法：选取2011年8月-2013年1月本院收治的肱骨干骨折患者70例，按随机数字表法分为观察组（n=38）和对照组（n=32）。观察组采用带锁髓内针固定治疗，对照组采用微创钢板固定治疗，记录两组患者手术时间、术中出血量、并发症、骨折愈合时间、骨折愈合率、肩关节功能评分等，以评价不同固定方法的效果。结果：观察组手术时间为（94±30）min，术中出血量为（76±51）mL；对照组分别为（126±37）min、（138±57）mL，观察组手术时间和术中出血量明均显少于对照组（P<0.05）。观察组骨折愈合时间为（10.27±1.76）周，肩关节功能评分为（97±5）分；对照组分别为（10.45±2.22）周、（95±6）分，两组骨折愈合时间和肩关节功能评分比较差异无统计学意义（P>0.05）。观察组并发症发生率为15.8%（6/38），对照组为21.9%（7/32），两组比较差异无统计学意义（P>0.05）。结论：与微创钢板固定治疗肱骨干骨折相比较，带锁髓内针固定治疗虽然在骨折愈合时间和肩关节功能评分方面无明显优势，但是可以有效缩短手术时间，减少术中出血量，且并发症发生率较低，在临床中根据患者症状，值得进行合理选择。