| 微创钢板接骨术治疗老年肱骨近端骨折的病例对照研究 |
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Received:December 23, 2011
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王剑锋 |
WANG Jian-feng |
海宁市中医院,浙江 海宁 314400 |
The Traditional Chinese Medicine Hospital of Haining,Haining 314400,Zhejiang,China |
jxwangjianfeng@hotmail.com |
| 宋海波 |
SONG Hai-bo |
海宁市中医院,浙江 海宁 314400 |
The Traditional Chinese Medicine Hospital of Haining,Haining 314400,Zhejiang,China |
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| 顾豪杰 |
GU Hao-jie |
海宁市中医院,浙江 海宁 314400 |
The Traditional Chinese Medicine Hospital of Haining,Haining 314400,Zhejiang,China |
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| 凌志丹 |
LING Zhi-dan |
海宁市中医院,浙江 海宁 314400 |
The Traditional Chinese Medicine Hospital of Haining,Haining 314400,Zhejiang,China |
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| 马海红 |
MA Hai-hong |
海宁市中医院,浙江 海宁 314400 |
The Traditional Chinese Medicine Hospital of Haining,Haining 314400,Zhejiang,China |
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| 期刊信息：《中国骨伤》2012年25卷，第6期，第487-489页 |
| DOI：10.3969/j.issn.1003-0034.2012.06.011 |
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目的: 探讨应用微创稳定系统(LISS)钢板的微创钢板接骨术(MIPO)与应用锁定加压钢板(LCP)切开复位内固定术(ORIF)治疗老年肱骨近端骨折的临床疗效.
方法: 2008年6月至2011年6月治疗肱骨近端骨折40例,分为微创组20例和常规组20例.微创组男8例,女12例；年龄68～74岁,平均(69.60±8.90)岁；Ⅱ部骨折15例,Ⅲ部骨折5例；左侧6例,右侧14例；采用肩外侧小切口闭合复位LISS钢板内固定治疗(即MIPO技术).常规组男6例,女14例；年龄67～74岁,平均(69.74±8.41)岁；Ⅱ部骨折13例,Ⅲ部骨折7例；左侧5例,右侧15例；采用肩关节前内侧切口切开复位锁定加压钢板(LCP)内固定(即常规ORIF).术中记录手术时间、出血量、切口长度.于术后第1、3、7天利用疼痛标尺评分记录患者伤肢疼痛情况,并随访记录肩关节功能Neer评分、骨折愈合时间,用Neer评分评价疗效.
结果: 微创组和常规组平均手术时间分别为(133.60±8.90) min和(132.70±8.41) min,术中出血量分别为(155.20±19.07) ml和(324.05±48.32) ml,切口长度分别为(8.15±1.89) cm和(13.05±1.95) cm,术后第1、3、7天疼痛值分别为(6.20±2.39)分和(8.33±3.01)分,(3.83±2.09)分和(5.31±2.22)分,(1.22±0.89)分和(3.13±1.75)分.Neer评分分别为93.16±2.55和80.31±2.22,骨折愈合时间分别为(6.60±2.33)个月和(8.93±3.41)个月.两组在术中出血量、切口长度、术后疼痛、Neer评分及骨折愈合时间方面比较差异均有统计学意义,微创组优于常规组.两组手术时间差异无统计学意义.根据Neer评分,微创组优13例,良2例,中5例；常规组优6例,良5例,中9例.
结论: 与常规ORIF相比,MIPO技术治疗老年肱骨近端骨折可给予良好的固定,且具有创伤小、显露简单、术中失血量少、术后肩关节功能恢复佳等优点,是一种较好的内固定方法. |
| [关键词]:外科手术,微创性 骨折固定术 肩骨折 病例对照研究 |
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| Case-control study on minimally invasive plate osteosynthesis for the treatment of proximal humeurs fractures in elderly patients |
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Abstract:
Objective: To compare clinical efficacy for the treatment of proximal humeurs fractures in elderly patients between the minimally invasive plate osteosynthesis (MIPO) with less invasive stabilization system (LISS) and the open reduction and internal fixation(ORIF) with locking compression plate(LCP).
Methods: From June 2008 to June 2011,40 elderly patients suffering from proximal humeurs fractures were divided into two groups:20 cases in minimally invasive group and 20 cases in routine group. Mini-incision approach from the lateral shoulder (minimally invasive group) and LISS can be chosen. It was short for MIPO. The antero-medial incision was used in routine group,LCP can be chosen in the method of ORIF. The operation time,the blood loss,the incision length,soreness at 1st,3rd and 7th days after operation were recorded. The postoperative Neer score,the healing time of bone were recorded. The curative effects were compared according to Neer score system.
Results: The mean operation times were (133.60±8.90) min and (132.70±8.41) min in minimally invasive group and routine group(P>0.05). The blood losses were (155.20±19.07) ml and(324.05±48.32) ml (P<0.05). The incision lengths were (8.15±1.89) cm and(13.05±1.95) cm (P<0.05). The pain scores on the 1st,3rd and 7th days after operation were (6.20±2.39) and (8.33±3.01)(P<0.05),(3.83±2.09) and (5.31±2.22)(P<0.05),(1.22±0.89) and (3.13±1.75) (P<0.05). The postoperative Neer scores were 93.16±2.55 and 80.31±2.22(P<0.05) and the healing times of bone were(6.60±2.33)months and(8.93±3.41) months(P<0.05). There were statistially differences in the blood losses,incision lengths,postoperative pain scores,postoperative Neer scores and the healing times of bone between two groups(P<0.05). The operation time between the two groups had no statistically different(P>0.05). According to Neer score system,13 patients obtained an excellent results,2 good,5 fair in minimally invasive group;6 patients obtained an excellent results,5 good,9 fair in routine group.
Conclusion: To compare with the routine group of ORIF, MIPO with LISS has the advantages of small incision,easier operation,less blood loss and improved postoperative shoulder joint function recovery for treatment of proximal humeurs fracture in elderly patients. It is another better method of internal fixation. |
| KEYWORDS:Surgical procedures,minimally invasive Fracture fixation Shoulder fractures Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王剑锋,宋海波,顾豪杰,凌志丹,马海红.微创钢板接骨术治疗老年肱骨近端骨折的病例对照研究[J].中国骨伤,2012,25(6):487~489 |
| 英文格式: | WANG Jian-feng,SONG Hai-bo,GU Hao-jie,LING Zhi-dan,MA Hai-hong.Case-control study on minimally invasive plate osteosynthesis for the treatment of proximal humeurs fractures in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(6):487~489 |
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