摘要
目的探讨带锁髓内钉与加压钢板内固定在肱骨骨折后骨不连治疗中的应用价值。方法选取2018年4月至2019年4月山东中医药大学附属医院收治的76例肱骨骨折后骨不连患者,根据手术方式的不同分为髓内钉组(40例,采用带锁髓内钉内固定治疗)和加压钢板组(36例,采用加压钢板内固定治疗)。比较两组的手术时间、切口长度、术中出血量、手术效果、术后并发症发生情况等。结果两组手术时间比较差异无显著性(P>0.05)。髓内钉组的切口长度、住院时间、骨折愈合时间明显短于加压钢板组,术中出血量、术后引流量明显低于加压钢板组,差异有显著性(P<0.05)。髓内钉组的手术治疗优良率为95.00%,明显高于加压钢板组的83.33%,差异显著性(P<0.05)。末次随访时两组的日常生活能力评分均明显低于术前,且髓内钉组明显低于加压钢板组,差异显著性(P<0.05)。髓内钉组的术后并发症总发生率为2.50%,明显低于加压钢板组的16.67%,差异显著性(P<0.05)。结论与加压钢板内固定相比,带锁髓内钉内固定治疗肱骨骨折后骨不连的手术创伤小,术后并发症少,骨折愈合效果良好。
Objective To compare the value of interlocking intramedullary nail and compression plate in the treatment of nonunion after humeral fracture.Method 76 cases of nonunion after humeral fracture in Affiliated Hospital of Shandong University of traditional Chinese Medicine were divided into two groups:group A(40 cases)treated with interlocking intramedullary nail and group B(36 cases)treated with compression plate.The operation time,incision length,bleeding volume,operation effect and postoperative complications of the two groups were analyzed retrospectively.Result There was no significant difference in operation time between the two groups(P>0.05).The incision length,hospitalization time and fracture healing time of group A were significantly shorter than those of group B,and the amount of intraoperative bleeding and postoperative drainage were significantly lower than those of group B(P<0.05).The excellent and good rate of surgical treatment was 95.00%in group A and 83.33%in group B.There was significant difference between the two groups(P<0.05).Compared with before operation,the scores of ADL in the last follow-up were significantly lower in both groups,and the scores of ADL in the last follow-up in group A were significantly lower than those in group B(P<0.05).The total incidence of postoperative complications in group A was 2.50%,which was significantly lower than that in group B(16.67%,P<0.05).Conclusion Compared with compression plate internal fixation,interlocking intramedullary nail internal fixation has smaller incision,less bleeding,less postoperative complications and better fracture healing effect.
作者
于汉通
卞泗善
Yu Hantong;Bian Sishan(Shandong University of Traditional Chinese Medicine,Shandong Jinan 250000,China;Department of Orthopedics,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Jinan 250000,China)
出处
《中国医刊》
CAS
2020年第10期1092-1095,共4页
Chinese Journal of Medicine
基金
山东省自然科学基金面上项目(ZR2014HM085)。
关键词
加压钢板
带锁髓内钉
肱骨骨折
骨不连
内固定术
Compression plate
Interlocking intramedullary nail
Humerus fracture
Nonunion
Internal fixation
