【摘要】 目的研究弹性髓内针逆行髓内固定治疗学龄儿童严重移位肱骨近端骨折的临床效果。方法回顾性分析大连市第二人民医院骨外科2015年3月—2017年3月收治的64例严重移位肱骨近端骨折学龄儿童临床资料,男性33例,女性31例;年龄6～16岁,平均9.56岁;左侧33例,右侧31例。根据手术方式不同分为弹性髓内针逆行髓内固定组(髓内针内固定组)和肱骨锁定钢板内固定组(钢板内固定组),比较两组儿童手术时间、术中出血量、住院时间、骨折愈合时间、术后肩关节Neer评分以及并发症发生率。结果两组儿童获得良好随访,时间12～36个月,平均16.75个月。髓内针内固定组儿童的术中出血量(24.23±5.91)mL少于钢板内固定组(65.58±15.81)mL,切口长度(4.11±1.12)cm短于钢板内固定组(8.91±2.71)cm,差异有统计学意义(P<0.05);两组住院时间、手术时间、术后骨折愈合时间、术后肩关节Neer评分的优良率和并发症发生率差异无统计学意义(P>0.05)。结论弹性髓内针逆行髓内固定治疗学龄儿童严重移位肱骨近端骨折,手术创伤小,值得临床推广。更多还原

【Abstract】 Objective To investigate the clinical effect of elastic intramedullary needle retrograde intramedullary fixation for severe displaced proximal humerus fractures in school age children. Methods Totally 64 cases of severely displaced proximal humeral fractures of school age children were admitted and treated in our hospital from Mar. 2015 to Mar. 2017. Their clinical data of patients was analyzed retrospectively. According to different surgical methods,the patients were divided into the retrograde intramedullary fixation group with elastic intramedullary needle group(intramedullary needle internal fixation group) and the internal fixation group with humeral locking plate group(plate internal fixation group). Surgical time,intraoperative blood loss,length of hospital stay,fracture healing time,postoperative Neer score of and shoulder joint incidence of complications were recorded and compared in the two groups. Results Patients in the intramedullary needle retrograde intramedullary fixation group and the humeral locking plate internal fixation group were followed up for 12-36 months,with an average of 16.75 months. Intraoperative blood loss and incision length of patients in the intramedullary needle internal fixation group were better than those in the humeral locking plate internal fixation group,and the difference was statistically significant(P<0.05). Hospitalization time,operation time,postoperative fracture healing time,postoperative Neer score of shoulder joint,and incidence of complications were compared,and the difference was not statistically significant(P>0.05). Conclusion Retrograde intramedullary fixation with elastic intramedullary needle for severe displaced proximal humerus fractures in school age children has a better clinical effect and is recommended for the treatment of severe displaced proximal humerus fractures.更多还原