内侧柱支撑重建术对肱骨近端骨折的临床效果及对关节功能的改善作用分析
[摘要] 目的 探討内侧柱支撑重建术对肱骨近端骨折的临床效果及对关节功能的改善作用。方法 方便选取2013年6月—2017年6月在该院接受肱骨近骨端手术患者100例，根据手术方法不同分为研究组50例和对照组50例。观察患者术后骨折部位恢复情况，关节活动度，肩关节上举、外翻角度以及肱骨头内翻角度和肱骨颈干角度。结果 研究组患者住院时间（7.58±1.42）d、骨折部位痊愈时间（57.89±10.89）d、完全康复时间（85.89±17.67）d患者均显著小于对照组（P<0.05）。术后，研究组患者的肘关节（96.80±10.67）分和肩关节功能（85.54±9.36分）、Neer评分（78.57±8.35）分均高于对照组患者，差异有统计学意义（P<0.05）。且术后肩关节上举（109.34±9.45）°、外翻角度（24.46±3.67）°大于对照组患者，肱骨头内翻角度（1.27±0.24）°和肱骨颈干角度（2.56±0.68）°均小于对照组，差异有统计学意义（P<0.05）。结论 内侧柱支撑重建术对肱骨近端骨折具有较好的临床效果，能够促进关节功能恢复。
[关键词] 内侧柱支撑肱骨；近端骨折；关节功能
[中图分类号] R274 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0006-03
[Abstract] Objective This paper tries to study the clinical effect of reconstructing the medial column support in treating the proximal humerus fracture and its effect in improving the function of patients’ joint. Methods 100 patients treated in this department from June 2013 to June 2017 were conveient selected. And equally divided into study group and control group， according to different therapeutic method. And the recovery of postoperative in fracture site， the activity of the joints， the rotation angle of the shoulder ， and the angle of the humeral head and the humerus neck were observed. Results The time of hospitalization （7.58±1.42）d， the recovery time of fracture site（57.89±10.89）d and the complete recovery time （85.89±17.67）d were significantly lower than those of the control group （P<0.05）. After surgery， the elbow （96.80±10.67）points and shoulder function （85.54±9.36）points and Neer score（78.57±8.35）points were significantly higher in the study group than those in the control group （P<0.05）. The shoulder lift after surgery（109.34±9.45）° and the valgus angle （24.46±3.67）° was higher than that of the control group. Humerus head varus angle（1.27±0.24）° and the angle of humeral neck（2.56±0.68）° were lower than those of the control group， and there was significant difference（P<0.05）. Conclusion The clinical effect of reconstructing the medial column support in treat the proximal humerus fracture is better， and can promote the recovery of joint’s function.
[Key words] The medial column supports the humerus； Proximal fracture； Joint function
近年来由于我国人口老龄化，该部位骨折在骨质疏松的中老年患者中较为普遍[1]。对于肱骨近端粉碎性骨折和移位较重的中老年患者，目前在治疗上比较棘手[2-3]。肱骨近端锁定接骨板（locking proximal humeral plate，LPHP），由于对机体软组织损伤较小、固定可靠和把持力强等优点，在临床上应用日渐广泛[4]。有研究表明，肱骨近端骨折的手术中，恢复肱骨近端内侧柱的完整性，能够有效维持骨折复位、避免内固定失败和防止复位后高度丢失[5-6]。因此，该文方便选取2013年6月—2017年6月在该院接受肱骨近骨端手术患者100例，来探究内侧柱支撑重建术对肱骨近端骨折的临床效果及对关节功能的改善作用。
1 资料与方法