实用医学杂志 ›› 2023, Vol. 39 ›› Issue (15): 1901-1906.doi: 10.3969/j.issn.1006-5725.2023.15.008

• 临床研究 • 上一篇    下一篇

单排锚钉联合骨隧道与钢板治疗肱骨大结节骨折的疗效比较 

刘国印1 吕德珍2 施巍3 王婷婷1 陈建民1 汪勇4   

  1.  南京医科大学金陵临床医学院 1 骨科,2 麻醉科,4 门诊部(南京 210000);3 军委后勤保障部军事医学交流 合作中心(北京 100071) 
  • 出版日期:2023-08-10 发布日期:2023-08-10
  • 通讯作者: 汪勇 E-mail:282917354@qq.com
  • 基金资助:
    国家自然科学基金青年科学基金项目(编号:82102547);江苏省自然科学基金面上项目(编号:BK20181113)

A clinical analysis of single row anchor combined with bone tunnel and proximal humeral plate in treat⁃ ment of greater tuberosity fractures of humerus 

LIU Guoyin, LÜ Dezhen, SHI Wei, WANG Tingting, CHEN Jianmin, WANG Yong.    

  1. Department of Orthopaedics, Jinling Hospital of Nanjing Medical University, Nanjing 210000, China 
  • Online:2023-08-10 Published:2023-08-10
  • Contact: WANG Yong E⁃mail:282917354@qq.com ​

摘要:

目的 探讨单排锚钉联合骨隧道(SRA-BT)和肱骨近端钢板(PHP)在肱骨大结节(GT)骨折 中的疗效。方法 回顾性分析 2017 年 6 月至 2021 年 6 月间接诊的 44 名 GT 骨折患者,按手术方式分为 SRA-BT 组(n = 18)和 PHP 组(n = 26)。比较两组围术期相关指标、合并症、骨折愈合及术后 GT 移位距离, 并采用 VAS 评分、ASES 评分和量角器测量分别对术后 6 个月时的疼痛程度、功能状况和活动度(ROM)进行评估。结果 PHP 组切口长度、手术时间、术中出血量和住院总费用均显著高于 SRA-BT 组(P < 0.05), SRA-BT 组术后 GT 移位距离大于 PHP 组(P < 0.05),两组术后并发症间差异无统计学意义(P > 0.05)。两 组术后静息 VAS 和活动 VAS 均优于术前(P < 0.05),但两组间比较差异无统计学意义(P > 0.05);两组术 后 ASES 评分均优于术前(P < 0.05),但 SRA-BT 组高于 PHP 组(P < 0.05)。前屈和外展时 SRA-BT 组的最 大 ROM 均优于 PHP 组(P < 0.05),但 0°外旋和 90°内旋时两组间均差异无统计学意义(P > 0.05)。结论 SRA-BT 与 PHP 治疗 GT 骨折均能获得良好的临床疗效和预后,但 SRA-BT 明显降低了医疗费用,且具有手术创伤小,不需二次手术的优点。

关键词: 肱骨, 大结节骨折, 单排锚钉, 骨隧道, 钢板

Abstract:

Objective To investigate the clinical efficacy of single row anchor combined with bone tunnel (SRA-BT) and proximal humeral plate (PHP) in treatment of greater tuberosity (GT) fractures of humerus. Methods The medical records of 44 patients with GT fracture admitted from June 2017 to June 2021 were retrospectively analyzed. They were divided into SRA-BT group (18 cases)and PHP group (26 cases)by different surgical methods. Perioperative related indicators,complications,bone healing, and postoperative re-displacement distance of GT were compared between the two groups. VAS,ASES and protractor measurements were used to evaluate the pain degree , function status and range of motion (ROM) at 6 months follow-up , respectively. Results The length of incision,operation time,intraoperative blood loss and in-patients costs in PHP group was significantly higher than that in SRA-BT group (P < 0.05). The re-displacement distance of GT in SRA-BT group was greater than that of PHP group (P < 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05). The postoperative VAS scores at rest and activity in the two groups were significantly better than those in preoperative (P < 0.05), but there was no significant difference between the two groups (P > 0.05). The postoperative ASES scores of the two groups were significantly better than that in preoperative (P < 0.05), and the postoperative ASES scores of SRA-BT group were higher than those in PHP group(P < 0.05).The ROM of the RA-BT group was better than that of the PHP group during flexion and abduction (P < 0.05), but there was no significant difference between the two groups at 0 ° external rotation and 90 ° internal rotation (P > 0.05). Conclusion Both SRA-BT and PHP can achieve good clinical efficacy and prognosis in the treatment of GT fractures. However, SRA-BT has the advantages of less trauma, low cost, relatively few postoperative complications, and no need for a second operation. 

Key words: humerus, greater tuberosity fractures, single row anchor, bone tunnel, plate ,