Multiloc髓内钉与肱骨近端锁定钢板治疗NeerⅡ型老年肱骨外科颈骨折的效果对比

摘要
图/表
参考文献(25)
相关文章 (0)

全文: PDF (518 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的比较Multiloc髓内钉与肱骨近端锁定钢板治疗NeerⅡ型老年肱骨外科颈骨折的效果。方法回顾性选取2016年6月—2018年6月辽宁省本溪市中心医院收治的NeerⅡ型老年肱骨外科颈骨折200例患者的临床资料，其中采用Multiloc髓内钉治疗的患者有99例纳入A组，采用肱骨近端锁定钢板治疗的患者有101例纳入B组。术后采用门诊复查或电话等方式对患者进行随访。比较两组末次随访的临床效果、临床相关指标、末次随访肩关节功能及疼痛情况，比较两组术后并发症情况。结果两组末次随访的优良率比较，差异无统计学意义（P ＞ 0.05）；两组切口长度、手术时间、术中出血量及术后骨折愈合时间比较，差异无统计学意义（P ＞ 0.05）；而A组术后1 d颈干角大于B组（P ＜ 0.05）；两组末次随访肩关节活动度、Constant-Murley评分及视觉模拟评分比较，差异无统计学意义（P ＞ 0.05）；两组术后并发症发生率比较，差异无统计学意义（P ＞ 0.05）。结论对NeerⅡ型老年肱骨外科颈骨折采用Multiloc髓内钉与肱骨近端锁定钢板两种手术方式治疗效果均较好，但Multiloc髓内钉采用“钉中钉”的内固定方式，在有效控制肱骨骨折端的旋转的同时术后1 d颈干角恢复较优，临床可综合患者实际情况选择合适的手术方式治疗。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘冰张强张明

关键词 ：老年肱骨外科颈骨折, NeerⅡ型, Multiloc髓内钉, 肱骨近端锁定钢板

Abstract：Objective To compare the effect of Multiloc intramedullary nail and proximal humeral locking plate in the treatment of Neer Ⅱ type elderly humeral surgical neck fracture. Methods The clinical data of 200 cases of Neer Ⅱ type elderly humeral surgical neck fracture who were admitted to Benxi Central Hospital from June 2016 to June 2018 were retrospectively selected. Among them, 99 patients treated with Multiloc intramedullary nail were included in group A， and 101 patients treated with proximal humeral locking plate were included in group B. The patients were followed up by outpatient reexamination or telephone. The clinical effects, clinical related indicators, shoulder joint function and pain of the last follow-up were compared between the two groups, and the complications after operation were compared between the two groups. Results There was no significant difference in the excellent and good rate at the last follow-up between the two groups (P ＞ 0.05). There were no significant differences in incision length, operation time, intraoperative bleeding volume and fracture healing time after operation between the two groups (P ＞ 0.05). The neck shaft angle of group A was bigger than that of group B on the one day after operation (P ＜ 0.05). There were no significant differences in shoulder range of motion, Constant-Murley score and visual analogue scale score between the two groups at the last follow-up (P ＞ 0.05). There was no significant difference in the incidence rate of complications after operation between the two groups (P ＞ 0.05). Conclusion Multiloc intramedullary nail and proximal humeral locking plate are effective for Neer Ⅱ type elderly humeral surgical neck fracture, but Multiloc intramedullary nail with “nail in nail” internal fixation method at the same time on the effective control the rotation of humerus fracture end has better recovery of neck shaft angle one day after operation. According to the actual situation of the patients, the appropriate surgical treatment can be selected in clinic.

Key words： Elderly humeral surgical neck fracture Neer Ⅱ type Multiloc intramedullary nail Proximal humeral locking plate

基金资助: 辽宁省卫生计生委科研课题（20150104）。

作者简介: 刘冰（1976.9-），男，副主任医师；研究方向：骨外科。

引用本文:

刘冰张强张明. Multiloc髓内钉与肱骨近端锁定钢板治疗NeerⅡ型老年肱骨外科颈骨折的效果对比[J]. 中国医药导报, 2020, 17(30): 91-94.
LIU Bing ZHANG Qiang ZHANG Ming. Effect contrast of Multiloc intramedullary nail and proximal humeral locking plate in the treatment of Neer Ⅱ type elderly humeral surgical neck fracture. 中国医药导报, 2020, 17(30): 91-94.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I30/91

[1] Cai P，Yang Y，Xu Z，et al. Anatomic locking plates for complex proximal humeral fractures：anatomic neck fractures versus surgical neck fractures [J]. J Shoulder Elbow Surg，2019，28（3）：476-482.
[2] Huang H. Treatment of the surgical neck fracture of the humerus with a novel external fixator in the elderly with osteoporosis: biomechanical analysis [J]. BMC Musculoskelet Disord，2019，20（1）：218.
[3] Shaw L，Hong CK，Kuan FC，et al. The incidence of occult and missed surgical neck fractures in patients with isolated greater tuberosity fracture of the proximal humerus [J]. BMC Musculoskelet Disord，2019，20（1）：482.
[4] Cho CH，Kim DH，Kim BS. Radiographic and clinical results of tension suture fixation using two washers with PHILOS plate for proximal humeral fractures [J]. Injury，2017，48（2）：464-468.
[5] 许猛子，周君琳，宋华伟，等.Multiloc髓内钉与Philos锁定钢板治疗肱骨近端骨折疗效对比研究[J].国际外科学杂志，2018，45（3）：168-172.
[6] Helfen T，Siebenbürger G，Mayer M，et al. Operative treatment of 2-part surgical neck fractures of the proximal humerus (AO 11-A3) in the elderly：Cement augmented locking plate PhilosTM vs. proximal humerus nail MultiLoc? [J]. BMC Musculoskelet Disord，2016，17（1）：448.
[7] 吴其鹏，刘国辉，夏天，等.Multiloc髓内钉治疗肱骨近端二、三部分骨折[J].临床骨科杂志，2017，20（2）：251.
[8] 徐炜，唐献忠.锁骨钩钢板与锁骨外侧延伸端锁定接骨板治疗Neer Ⅱ型锁骨远端骨折的效果比较[J].中国医药导报，2015，12（12）：25-28.
[9] 姜自伟，欧阳崇志，黄枫，等.肱骨近端骨折改良Neer分型的四部评分法[J].中医正骨，2015，27（9）：64-66.
[10] Agel J，Jones CB，Sanzone AG，et al. Treatment of proximal humeral fractures with Polarns nail fixation [J]. J Shoulder Elbow Surg，2004，13（2）：191-195．
[11] Hirschmann MT，Wind B，Amsler F，et al. Reliability of shoulder abduction strength measure for the Constant-Murley score [J]. Clin Orthop Relat Res，2010，468（6）：1565-1571.
[12] 杨国勇，向明，陈杭，等.Multiloc髓内钉治疗肱骨近端骨折的近期疗效[J].中华骨科杂志，2016，36（2）：103-112.
[13] Yang TC，Su YP，Chang MC. The elderly have similar outcomes compared to younger patients after ORIF with locking plate for comminuted proximal humerus fracture [J]. Acta Orthop Traumatol Turc，2019，53（1）：1-5.
[14] 邵勇.肱骨外科颈骨折保守治疗和手术治疗的临床研究[J].黑龙江医药，2019，32（6）：1473-1474.
[15] 王成龙，罗岳，李存宽.骨创治疗仪联合骨愈灵胶囊辅助治疗创伤性骨折临床研究[J].国际中医中药杂志，2019，41（7）：1333-1337.
[16] 齐新文，王兆杰，邝立鹏，等.Philos系统治疗老年骨质疏松性肱骨外科颈骨折[J].实用骨科杂志，2011，17（11）：976-979.
[17] 吴京亮，魏志凌，魏更生，等.Multiloc髓内钉内固定治疗Neer二部分肱骨外科颈骨折[J].中国骨与关节损伤杂志，2018，33（7）：755-756.
[18] 单记春，邵银初，邹鸿星，等.复杂肱骨近端骨折Philos钢板内固定手术技巧及并发症分析[J].中国骨与关节损伤杂志，2018，33（9）：989-991.
[19] 柯铁，张永发，许志贤，等.肩峰下前外侧入路复位锁定钢板内固定治疗肱骨近端骨折的疗效[J].中华创伤杂志，2019，35（11）：1017-1023.
[20] 邹义源，向明，陈杭，等.Neer二部分肱骨外科颈骨折微创治疗：Phlios钢板与Multiloc髓内钉对比[J].中国组织工程研究，2018，22（19）：2981-2987.
[21] 陈锐鸿，葛鸿庆，管华，等.Multiloc髓内钉与锁定钢板治疗老年肱骨外科颈骨折的临床研究[J].实用骨科杂志，2019，25（4）：297-300.
[22] 杨红胜，贺军，潘显明，等.骨皮质剥脱术治疗非感染性股骨干骨不连的临床效果研究[J].成都医学院学报，2020， 15（4）：452-456.
[23] Kloub M， Holub K，Urban J，et al. Intramedullary nailing of displaced four-part fractures of the proximal humerus [J]. Injury，2019，50（11）：1978-1985.
[24] 董云鹏，吕朝晖，李伟举，等.锁定钢板与髓内钉治疗老年性肱骨外科颈骨折的疗效观察[J].中国中医骨伤科杂志，2017，25（6）：48-50.
[25] 柯志勇.肱骨近端锁定钢板与髓内钉治疗NeerⅡ型肱骨外科颈骨折的临床疗效[J].临床医学工程，2017，24（5）：685-686.