【摘要】 目的观察微创锁定接骨板治疗对肱骨近端骨折肩关节功能的影响。方法回顾性分析2015年6月~2016年6月大连市第二人民医院收治的外伤性肱骨近端骨折63例患者的临床资料,根据手术方法不同分为微创组(31例),传统组(32例)。微创组采用微创锁定接骨板内固定术,传统组采用传统切开复位内固定术。比较两组患者一般情况(包括手术时间、术中出血量、住院时间)、疼痛、肩关节功能恢复情况、患者满意度及不良事件发生情况进。结果微创组手术时间、住院时间短于传统组,术中出血量少于传统组(P<0.05)。术后7 d微创组VAS评分低于传统组(P<0.05)。术后3、6个月两组VAS评分比较,差异无统计学意义(P>0.05)。术后15 d微创组Neer肩关节功能评分优良率高于传统组(P<0.05),术后3、6个月两组Neer肩关节功能评分优良率差异无统计学意义(P>0.05)。微创组满意度高于传统组(P<0.05)。两组均发生严重不良事件。结论与传统切开复位内固定术相比,微创锁定接骨板治疗肱骨近端骨折手术时间短、出血量少、住院时间短,早期即可恢复肩关节功能,且疼痛较轻,患者满意度高。更多还原

【Abstract】 Objective To explore the effects of minimally invasive percutaneous osteosynthesis on shoulder function of proximal humeral fractures. Methods A total of 63 clinical data of patients with proximal humeral fractures treated in the Second People′s Hospital of Dalian City from June 2015 to June 2016 were reviewed retrospectively and divided into the minimally invasive group(31 cases) and the traditional invasive group(32 cases) according to the different operation methods. The minimally invasive group was treated with minimally invasive percutaneous osteosynthesis and the traditional invasive group was treated with open reduction and internal fixation. The general situation(including operation time, intraoperative blood loss, hospital stays), pain degree, the recovery of shoulder function, patients′ satisfaction and the adverse reactions were compared between the two groups. Results The operation time, intraoperative blood loss,hospital stays in the minimally invasive group were shorter or less than those of the traditional invasive group(P < 0.05).After 7 d operation, the VAS score of the minimally invasive group was lower than that of traditional invasive group(P <0.05). There were no significant differences in VAS scores between the two groups in 3, 6 months after operation(P > 0.05).After 15 d operation, the excellent and good rate of Neer shoulder function score of minimally invasive group was higher than that of the traditional invasive group(P < 0.05). There were no significant differences in excellent and good rate of Neer shoulder function score between the two groups in 3, 6 months after operation(P > 0.05). The patients′ satisfaction in the minimally invasive group was higher than that of traditional invasive group(P < 0.05). Conclusion Compared with open reduction and internal fixation, minimally invasive percutaneous osteosynthesis in the treatment of proximal humeral fractures has shorter operation time and hospital stays, less intraoperative blood loss, faster shoulder function recovery, less pain and higher patients′ satisfaction.更多还原