| 肩峰下前外侧入路治疗肱骨近端2或3部分骨折病例对照研究 |
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Received:October 26, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 宋正鑫 |
SONG Zheng-xin |
北京京煤集团总医院骨科, 北京 102300 |
Department of Orthopaedics, Beijing Jing Mei Group General Hospital, Beijing 102300, China |
s.zhxin@163.com |
| 刘岩 |
LIU Yan |
北京京煤集团总医院骨科, 北京 102300 |
Department of Orthopaedics, Beijing Jing Mei Group General Hospital, Beijing 102300, China |
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| 毛英夫 |
MAO Ying-fu |
北京京煤集团总医院骨科, 北京 102300 |
Department of Orthopaedics, Beijing Jing Mei Group General Hospital, Beijing 102300, China |
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| 李丙岩 |
LI Bing-yan |
北京京煤集团总医院骨科, 北京 102300 |
Department of Orthopaedics, Beijing Jing Mei Group General Hospital, Beijing 102300, China |
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| 卫力晋 |
WEI Li-jin |
北京京煤集团总医院骨科, 北京 102300 |
Department of Orthopaedics, Beijing Jing Mei Group General Hospital, Beijing 102300, China |
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| 田耘 |
TIAN Yun |
北京大学第三医院骨科, 北京 100191 |
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| 期刊信息：《中国骨伤》2017年30卷，第3期，第227-232页 |
| DOI：10.3969/j.issn.1003-0034.2017.03.008 |
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目的：探讨应用肩峰下前外侧入路治疗肱骨近端2、3部分骨折的临床疗效。
方法：回顾分析2010年1月至2014年6月收治的42例肱骨近端2、3部分骨折患者临床资料，其中男23例，女19例，年龄40～76岁，平均61.5岁；应用肩峰下前外侧入路的患者22例，其余20例采用传统的胸大肌三角肌入路。比较两组手术操作时间、术中出血量、术后住院天数、骨折愈合时间，使用VAS评分评估术后1周肩关节疼痛程度，使用肩关节Constant评分评估肩关节术后3个月及6个月以上肩关节功能水平。
结果：所有患者完成至少14个月的随访。两组比较，手术时间（P=0.003）、术中出血量（P=0.001）、术后住院天数（P=0.013）、术后1周肩关节疼痛VAS评分（P=0.026）、术后3个月Constant评分（P=0.014），肩峰下前外侧入路组与胸大肌三角肌入路组间差异有统计学意义；骨折临床愈合时间（P=0.462）、术后6个月以上Constant 评分（P=0.204），肩峰下前外侧入路组与胸大肌三角肌入路组间差异无统计学意义。未出现肱骨头坏死、内固定断裂的情况。
结论：应用肩峰下前外侧入路治疗肱骨近端2、3部分骨折，具有手术时间短、创伤小、术后疼痛轻、功能恢复快等优点。 |
| [关键词]:肱骨骨折，近端 肩骨折 肩峰 手术入路 病例对照研究 |
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| Anterolateral acromial approach for the treatment of proximal humerus in 2-or 3-part fractures-a case-control study |
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Abstract:
Objective: To explore the clinical curative effect of anterolateral acromial approach in treating two-and three-part of proximal humeral fractures.
Methods: Forty-two patients of proximal humeral fractures from January 2010 to June 2014 were analyzed retrospectively,including 23 males and 19 females with a mean age of 61.5 years old ranging from 40 to 76 years old. Among them,22 cases were treated with anterolateral acromial approach and 20 cases were treated with deltopectoral approach. The operation time,intraoperative blood loss,postoperative hospitalization days,fracture healing time of two groups were compared. The shoulder pain after 1 week was assessed by the VAS score. The postoperative shoulder joint function was evaluated after 3 months and more than 6 months by Constant score.
Results: The follow-up time was at final 14 months. There were significant differences in operation time(P=0.003),intraoperative blood loss(P=0.001),postoperative hospital day(P=0.013),postoperative shoulder pain after 1 week(P=0.026),postoperative Constant score after 3 months(P=0.014)between the anterolateral acromial approach group and the deltopectoral approach group. There were no significant differences in clinical union time of bone(P=0.462),postoperative constant score after more than 6 months(P=0.204)between the anterolateral acromial approach group and the deltopectoral approach group. There were no breakage of the internal fixation and humeral head osteonecrosis.
Conclusion: It has some advantages with anterolateral acromial approach to treat Neer two-and three-part of proximal humeral fractures,such as short operation time,less intraoperative bleeding,lighter postoperative pain,quicker recovery of function. |
| KEYWORDS:Humeral fractures,proximal Shoulder fractures Acromion Operative approach 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: | 宋正鑫,刘岩,毛英夫,李丙岩,卫力晋,田耘.肩峰下前外侧入路治疗肱骨近端2或3部分骨折病例对照研究[J].中国骨伤,2017,30(3):227~232 |
| 英文格式: | SONG Zheng-xin,LIU Yan,MAO Ying-fu,LI Bing-yan,WEI Li-jin,TIAN Yun.Anterolateral acromial approach for the treatment of proximal humerus in 2-or 3-part fractures-a case-control study[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(3):227~232 |
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