【摘要】 目的 分析经三角肌双间隙入路锁定钢板内固定手术治疗肱骨近端骨折的临床效果。方法 选取2020年2月—2024年6月临沂市中医医院收治的80例肱骨近端骨折患者，采用随机数字表法分为对照组与观察组，各40例。对照组行传统入路锁定钢板内固定术，观察组行经三角肌双间隙入路锁定钢板内固定手术。比较两组的手术相关指标、疼痛程度、骨折复位维持、肩关节功能及并发症。结果 观察组的术中出血量少于对照组，手术时间、住院时间及骨折愈合时间短于对照组，股骨头高度丢失值、颈干角丢失值、并发症总发生率低于对照组，差异均有统计学意义(P<0.05)。术后1周、1个月、3个月，观察组视觉模拟评分法评分低于对照组，差异有统计学意义(P<0.05)。术后3个月，观察组肩关节功能量表中的肩关节疼痛、肌力、主动活动范围、日常生活活动评分高于对照组，差异均有统计学意义(P<0.05)。结论 经三角肌双间隙入路锁定钢板内固定手术治疗肱骨近端骨折的出血量低、并发症少，术后疼痛较轻，骨折复位维持较好，利于肩关节功能恢复。更多还原

【Abstract】 Objective To analyze the therapeutic effect of locking plate internal fixation surgery through the double gap approach of the deltoid muscle in proximal humeral fractures. Methods A total of 80 cases of proximal humeral fractures who admitted to Linyi Hospital of Traditional Chinese Medicine from February 2020 to June 2024 were selected as the subjects. All selected cases were assigned to control group and observation group(40 cases each) with random numerical table. The patients of control group underwent the traditional approach of locking plate internal fixation surgery, while the patients of observation group underwent the approach of locking plate internal fixation surgery through the double gap approach of the deltoid muscle. The comparisons were performed on surgical-related indicators, pain degree, fracture reduction and maintenance, shoulder joint function and complications in both groups. Results The observation group demonstrated less intraoperative blood loss, shorter operation time, hospital stays and healing time of fracture, lower loss value of femoral head height and loss value of neck shaft angle, and lower overall incidence of complications compared with the control group(P < 0.05); The observation group had lowerpostoperative 1-week, 1-month, and 3-month visual analogue scale scores than the control group(P < 0.05); The observation group obtained higher scores of shoulder pain, muscle strength, active range of motion and activities of daily living in the Constant-Murley Shoulder Scoring Scale than the control group after operation for 3 months(P < 0.05). Conclusions For proximal humeral fractures, locking plate internal fixation surgery through the double gap approach of the deltoid muscle has low bleeding, few complications, milder postoperative pain, better fracture reduction and maintenance, and is conducive to the recovery of shoulder joint function.更多还原