自制爪形卡压钢板和空心螺钉固定治疗肱骨大结节骨折的前瞻性随机对照研究

印飞; 刘军; 殷渠东; 吴永伟; 陆尧; 马运宏; 黎逢峰; 芮永军

doi:10.13418/j.issn.1001-165x.2018.04.020

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (4) : 445-448. DOI: 10.13418/j.issn.1001-165x.2018.04.020

临床研究

自制爪形卡压钢板和空心螺钉固定治疗肱骨大结节骨折的前瞻性随机对照研究

印飞，　刘军，　殷渠东，　吴永伟，　陆尧，　马运宏，　黎逢峰，　芮永军

作者信息 +

Implantation of self-made claw-shaped press plate and hollow screw for the repair of the split fracture of greater tuberosity of humerus: a prospective, randomized, and controlled study

YIN Fei, LIU Jun, YIN Qu-dong, WU Yong-wei, LU Yao, MA Yun-hong, LI Fen-feng, RUI Yong-jun

Author information +

文章历史 +

摘要

目的　比较自制爪形卡压钢板与空心钉治疗肱骨大结节骨折的临床效果。方法　前瞻性地将2014年1月~2016年1月我科收治的符合纳入和排除标准的32例肱骨大结节骨折患者随机分为两组，分别施以自制爪形卡压钢板固定术（16例）和3枚空心钉固定术（16例）。两组术前一般资料比较差异无统计学意义（P>0.05），具有可比性。比较两组患者骨折愈合时间、VAS疼痛评分、美国肩肘外科协会（ASES）评分及Constant-Murley评分。结果　所有患者均获得随访，随访时间14~38个月，平均21.2个月。两组患者在骨折愈合时间及末次随访VAS疼痛评分相比，差异无统计学意义(P>0.05)。两组在末次随访时ASES评分及Constant-Murley评分比较差异有统计学意义(P<0.05)，自制爪形卡压钢板组优于空心螺钉组。结论　自制爪形卡压钢板治疗肱骨大结节骨折，内固定牢靠，便于患者早期功能锻炼，术后功能恢复较空心钉内固定好，值得临床推广。

Abstract

Objective To compare the recovery of shoulder function after conventional self-made claw-shaped press plate and hollow-screw fixation for repair of the split fracture of greater tuberosity of humerus.　Mehtods　A prospective randomized controlled study was performed in 32 patients with split fracture of greater tuberosity of humerus who were assigned into 2 groups from January 2014 to January 2016. Group A (n=16) received treatment using self-made claw-shaped press plate and group B(n=16) received treatment using hollow-screw fixation. The fracture healing time ,VAS scores, the United States Scores of Shoulder, Elbow Surgeons and Constant and Murley Scoring Systems were utilized to assess the therapeutic outcomes. Results　The mean follow-up period was 21.2 months. Group A (n=16) was better than group B (n=16) in the United States Scores of Shoulder and Elbow Surgeons and Constant and Murley Scoring Systems(P<0.05). There was no significant differences in the VAS scores and fracture healing time (P>0.05). Conclusion The study suggests that self-made claw-shaped press plate in the repair of split fracture of greater tuberosite of humerus is an ideal fixation method with allowance for the early functional exercise.

导出引用

印飞，　刘军，　殷渠东，　吴永伟，　陆尧，　马运宏，　黎逢峰，　芮永军. 自制爪形卡压钢板和空心螺钉固定治疗肱骨大结节骨折的前瞻性随机对照研究[J]. 中国临床解剖学杂志. 2018, 36(4): 445-448 https://doi.org/10.13418/j.issn.1001-165x.2018.04.020

YIN Fei, LIU Jun, YIN Qu-dong, WU Yong-wei, LU Yao, MA Yun-hong, LI Fen-feng, RUI Yong-jun. Implantation of self-made claw-shaped press plate and hollow screw for the repair of the split fracture of greater tuberosity of humerus: a prospective, randomized, and controlled study[J]. Chinese Journal of Clinical Anatomy. 2018, 36(4): 445-448 https://doi.org/10.13418/j.issn.1001-165x.2018.04.020

参考文献

[1] 张晋, 鲁谊, 朱以明, 等. 肩关节镜辅助经皮空心钉或缝合锚固定治疗肱骨大结节骨折[J]. 中华创伤骨科杂志, 2010, 12(4): 303-307.
[2] 陆尧, 刘军, 芮永军, 等. 自制尖齿开口卡压钢板治疗撕脱性骨折[J]. 中国临床解剖学杂志, 2016, 34(5): 584-587.
[3] 陈焱, 邢丹谋, 任东, 等. 解剖型锁定钢板在肱骨大结节粉碎性骨折中的应用[J].中华骨科杂志, 2016, 36(16): 1009-1015.
[4] 吴剑宏, 吴腾飞, 王丹, 等. 肱骨大结节骨折向下移位的临床意义[J]. 中华创伤骨科杂志, 2016, 18(4): 277-282.
[5] 郭刚, 余斌, 陈滨, 等. 肱骨大结节移位骨折的手术治疗探讨[J]. 中华创伤骨科杂志, 2012, 14(8): 685-688.
[6] Bono CM, Renard R, Levine RG, et al. Effect of displacement of fractures of the greater tuberosity on the mechanics of the shoulder[J]. J Bone Joint Surg Br, 2001, 83(7): 1056-1062.
[7] 白露, 姜保国. 肱骨大结节骨折治疗的研究进展[J]. 中华创伤杂志, 2012, 28(2): 146-148.
[8] Ishak C, Sahajpal D, Chiang A, et al. Fixation of greater tuberosity fractures: a biomechanical comparison of three techniques[J]. Bull Hosp Jt Dis, 2006, 63(3-4): 98-99.
[9] 王刚, 李玉民. 肱骨大结节骨折的诊断与治疗[J]. 中华肩肘外科电子杂志, 2014, 2(2): 114-117.
[10] Schöffl V, Popp D, Strecker W. A simple and effective implant for displaced fractures of the greater tuberosity: the“Bamberg”plate[J]. Arch Orthop Trauma Surg 2011, 131(4): 509-512.
[11]Ji JH, Shafi M, Song IS, et al. Arthroscopic fixation technique for comminuted, displaced greater tuberosity fracture[J]. Arthroscopy, 2010, 26(5): 600-609.
[12]唐小松, 郭刚, 燕华, 等. 使用跟骨钢板治疗移位的肱骨大结节骨折[J]. 中国矫形外科杂志, 2012, 20(14): 1333-1334.
[13] Chen YF, Zhang W, Chen Q, et al. AO X-shaped midfoot locking plate to treat displaced isolated greater tuberosity fractures[J]. Orthopedics, 2013, 36(8): e995-e999.
[14] 王光勇, 杜俊生, 钟兵. 钢板和空心螺钉置入修复劈裂型肱骨大结节骨折:肩关节功能比较[J].中国组织工程研究, 2014, 18(40): 6482-6487.
[15] Schöffl V, Popp D, Strecker W. A simple and effective implant for displaced fractures of the greater tuberosity: the“Bamberg”plate[J]. Arch Orthop Trauma Surg 2011, 131(4): 509-512.