| 锁定钢板治疗Neer 3、4部分肱骨近端骨折的病例对照研究 |
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Received:February 25, 2013
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| 作者 | Author | 单位 | Unit | E-Mail |
| 章宁杰 |
ZHANG Ning-jie |
绍兴市中医院骨科, 浙江 绍兴 312000 |
Department of Orthopaedics, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing 312000, Zhejiang, China |
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| 蒋凌 |
JIANG Ling |
绍兴市中医院骨科, 浙江 绍兴 312000 |
Department of Orthopaedics, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing 312000, Zhejiang, China |
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| 周祖彬 |
ZHOU Zu-bin |
上海交通大学附属第六人民医院骨科, 上海 200233 |
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| 柴益民 |
CHAI Yi-min |
上海交通大学附属第六人民医院骨科, 上海 200233 |
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znjieppp@126.com |
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| 期刊信息：《中国骨伤》2014年27卷，第1期，第38-40页 |
| DOI：10.3969/j.issn.1003-0034.2014.01.010 |
| 基金项目:上海市科学技术委员会科研计划项目（编号：11JC1409400） |
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目的：比较运用锁定钢板治疗Neer 3、4部分肱骨近端骨折的疗效。
方法：自2009年1月至2011年6月，采用锁定钢板治疗64例Neer 3、4部分肱骨近端骨折。3部分骨折组39例，男16例，女23例；平均年龄（55.12±12.52）岁。4部分骨折组25例，男9例，女16例；平均年龄（57.92±13.14）岁。随访根据美国肩肘外科医师评分（American Shoulder and Elbow Surgeons score，ASES）评估患者肩关节功能，采用视觉模拟评分法（visual analogue scale，VAS）进行疼痛评分，并评价相关并发症。
结果：术后患者切口均I期愈合。64例均获随访，时间12～30个月，平均16.5个月。末次随访时，ASES评分3部分骨折（76.14±14.10）分，4部分骨折（65.93±11.82）分；VAS评分分别为2.12±1.63和3.90±2.21，以上指标两组比较差异均有统计学意义（P<0.05）.并发症发生率分别为20.51%和36.00%，差异无统计学意义。
结论：锁定钢板治疗肱骨近端3部分骨折的疗效优于4部分骨折，术中需争取解剖复位、稳定固定、选择合适长度的螺钉及钢板位置，术后合理功能锻炼以获得良好的疗效。 |
| [关键词]:肱骨骨折 骨折固定术,内 肩关节 病例对照研究 |
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| Case-control study on locking plates fixation for the treatment of Neer 3-and 4-part proximal humerus fractures |
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Abstract:
Objective: To compare therapeutic effects of locking plates for the treatment of Neer 3-and 4-part proximal humerus fractures.
Methods: From January 2009 to June 2011,64 patients with Neer 3-and 4-part proximal humerus fractures were treated with locked plate fixation. There were 39 patients in the 3-part group including 16 males and 23 females,with an average age of（55.12±12.52）years old;and 25 patients in the 4-part fractures group including 9 males and 16 females,with an average age of（57.92 ±13.14） years old. The American Shoulder and Elbow Surgeons score（ASES）,visual analogue scale（VAS）and complications were documented for analysis before and after treatment.
Results: All the patients had incision healing at the first stage. All the patients were followed up,and the duration ranged from 12 to 30 months,with a mean of 16.5 months. Comparably better shoulder function recovery was achieved in the 3-part fractures group with regard to the ASES（76.14±14.10 in the 3-part fractures group vs. 65.93 ±11.82 in the 4-part fractures group,P<0.05）. Moreover,a statistical difference（P<0.05） was observed regarding the VAS pain score（2.12±1.63 in the 3-part fractures group vs. 3.90±2.21 in the 4-part fractures group）. For the complications rate,no statistical difference was noted between 3-part fractures group and 4-part fractures group（20.51% vs. 36.00%）.
Conclusion: The clinical outcomes of the 3-part proximal humerus fractures is better than the 4-part fractures proximal humerus fractures treated with locking plate. Complex proximal humeral fractures treated with locking plates can be achieved a satisfactory outcome when attention is paid to anatomic reduction,stable fixation,proper screws and plate placement,and reasonable functional exercise postoperative. |
| KEYWORDS:Humerual fractures Fracture fixation,internal Shoulder joint 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: | 章宁杰,蒋凌,周祖彬,柴益民.锁定钢板治疗Neer 3、4部分肱骨近端骨折的病例对照研究[J].中国骨伤,2014,27(1):38~40 |
| 英文格式: | ZHANG Ning-jie,JIANG Ling,ZHOU Zu-bin,CHAI Yi-min.Case-control study on locking plates fixation for the treatment of Neer 3-and 4-part proximal humerus fractures[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(1):38~40 |
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