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(1)
[摘要] 目的 比較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。
[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
[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210(2020)10(c)-0091-04
Effect contrast of Multiloc intramedullary nail and proximal humeral locking plate in the treatment of Neer Ⅱ type elderly humeral surgical neck fracture
LIU Bing ZHANG Qiang ZHANG Ming
Department of Bone Surgery， Benxi Central Hospital， Liaoning Province， Benxi 117000， China
[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., http://www.100md.com(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
[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210(2020)10(c)-0091-04
Effect contrast of Multiloc intramedullary nail and proximal humeral locking plate in the treatment of Neer Ⅱ type elderly humeral surgical neck fracture
LIU Bing ZHANG Qiang ZHANG Ming
Department of Bone Surgery， Benxi Central Hospital， Liaoning Province， Benxi 117000， China
[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., http://www.100md.com(刘冰 张强 张明)