|
|
|
| Effect of Various Medial Column Supporting Screws on in the Treatment of Proximal Humeral Fracture with Locking Plate |
| HE Shi-ji, DANG Ya-jun |
| Department of Orthopedics, Yan'an People's Hospital, Yan'an Shaanxi 716000 |
|
|
|
|
Abstract 【Objective】 To investigate the effect of different numbers of medial column supporting screws on proximal humeral fracture with locking plate. 【Methods】 A retrospective analysis of the clinical data of 76 patients with proximal humeral fractures treated in the Orthopedics Department of our hospital from August 2017 to September 2018. They were divided into 4 groups based on the number of medial column support screws used in the surgery: There were 25 patients in the non-supporting screw group, 19 patients in the 1 supporting screw group, 17 patients in the 2 supporting screws group, and 15 patients in the 3 supporting screws group. During the follow-up of 12 months, the shear stiffness, compressive stiffness, fracture healing time, humeral head height loss value, neck shaft angle, varus angle, constant shoulder score and postoperative complications were compared between the four groups. 【Results】 The patients with three supporting screws had the highest shear stiffness and compressive stiffness, which were better than those without supporting screws, one supporting screw group and two supporting screw group (P<0.05). The fracture healing time without supporting screw, 1 supporting screw group, 2 supporting screws group, and 3 supporting screws group were (14.25 ± 2.30), (14.33 ± 2.45), (15.18 ± 3.51)and (15.68 ± 4.63),respectively. There were no statistically significant differences in fracture healing time and neck-shaft angle between the four groups (all P>0.05). The values of humeral head loss and varus angle in group A, group B, group C, and group D decreased sequentially, and the difference between the groups was statistically significant (P<0.05). The Constant scores of shoulder joint function increased gradually in groups A, B, C, and D at 1 month, 2 months, 3 months, 6 months, and 12 months after surgery. The Constant score of group D was the highest, and there were differences between the groups (P<0.05). The incidence of postoperative complications in the 3 supporting screws group, 2 supporting screws group, 1 supporting screw group, and no supporting screw group were 40%(10/25)、42.10% (8/19)、17.64% (3/17) and 13.34% (2/15), respectively. The differences of groups were not statistically significant (P> 0.05). 【Conclusion】 Choosing 2 or 3 screws to support the medial column can achieve a satisfactory recovery results the treatment of proximal humeral fractures with locking plate. The use of 3 supporting screws has the best clinical effect.
|
|
Received: 12 October 2020
|
|
|
|
|
|
[1] 郭伟军, 赵友明, 王新华,等. 锁定钢板治疗肱骨近端骨折内侧柱支撑螺钉数量与其疗效的相关性研究[J].中华骨科杂志, 2015, 35(1):40-47.
[2] 白建忠, 侯 波, 施慧峰,等. 锁定钢板与普通钢板置入内固定修复肱骨近端骨折的预后对比[J].中国组织工程研究, 2015, 19(26):4213-4217.
[3] 董强,刘冲.老年骨科手术患者术后认知功能障碍的危险因素分析[J].医学临床研究,2020,17(11):1717-1719.
[4] 李雪飞, 王林祥, 王铁军,等. 锁定髓内针系统与锁定钢板治疗老年肱骨近端骨折的临床疗效[J].中国老年学, 2015, 35(6):1681-1682.
[5] 朱剑, 吴斗, 赵恩哲,等. 唑来膦酸联合锁定钢板内固定治疗骨质疏松性肱骨近端骨折的疗效观察[J].中华创伤杂志, 2016, 32(11):1014-1018.
[6] 刘刚, 蒋协远. 股骨转子间不稳定型骨折内固定物的选择[J].中华骨科杂志, 2018, 38(22):1403-1412.
[7] 黄勇.组合式桥接内固定系统固定治疗儿童四肢干骺端骨折[J].中华创伤骨科杂志, 2020, 22(3):268-271.
[8] 马信龙, 马剑雄, 徐卫国,等. 骨科生物力学研究的测量方法学专家共识[J].中国骨质疏松杂志, 2014,20(9):1039-1054.
[9] 李百川, 张明, 徐友高,等. 中老年原发性冻结肩及肩袖钙化症的肩关节镜治疗[J].中国骨与关节损伤杂志, 2008,23(5):365-367.
[10] 张军, 庄云强, 李东贞,等. 锁定钢板结合异体腓骨支撑治疗老年肱骨近端Neer三、四部分骨折[J].中华创伤骨科杂志, 2018, 20(11):946-952.
[11] BIAZZO Y, CARDILE Y, BRUNELLI L, et al. Early results for treatment of two-and three-part fractures of the proximal humerus using contours PHP (Proximal humeral plate)[J].Acta Biomed,2017, 88(1):65-73.
[12] 沈施耘, 李雄峰, 吴猛,等. 锁定钢板结合不同腓骨植骨方式治疗肱骨近端骨折的生物力学稳定性分析[J].中华创伤骨科杂志, 2019, 21(5):427-431. |
|
|
|
2021, Vol. 38 
