[1]李世挺.锁定钢板治疗不同Neer分型肱骨近端骨折的疗效及生物力学恢复情况[J].医学信息,2022,35(23):108-111.[doi:10.3969/j.issn.1006-1959.2022.23.020]
　LI Shi-ting.The Efficacy and Biomechanical Recovery of Locking Plate in the Treatment of Different Neer Types of Proximal Humeral Fractures[J].Journal of Medical Information,2022,35(23):108-111.[doi:10.3969/j.issn.1006-1959.2022.23.020]
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锁定钢板治疗不同Neer分型肱骨近端骨折的疗效及生物力学恢复情况()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年23期
页码:
108-111
栏目:
临床研究
出版日期:
2022-12-01

文章信息/Info

Title:
The Efficacy and Biomechanical Recovery of Locking Plate in the Treatment of Different Neer Types of Proximal Humeral Fractures
文章编号:
1006-1959（2022）23-0108-04
作者:
李世挺
（天津市宁河区医院骨科，天津 301500）
Author(s):
LI Shi-ting
(Department of Orthopedics,Tianjin Ninghe District Hospital,Tianjin 301500,China)
关键词:
锁定钢板; 不同Neer分型; 肱骨近端骨折; 生物力学
Keywords:
Locking plate; Different Neer classification; Proximal humeral fracture; Biomechanics
分类号:
R683.4
DOI:
10.3969/j.issn.1006-1959.2022.23.020
文献标志码:
A
摘要:
目的 观察锁定钢板治疗不同Neer分型肱骨近端骨折的疗效及生物力学恢复情况。方法 选取2020年6月-2021年6月我院诊治的52例肱骨近端骨折患者为研究对象，其中NeerⅡ型18例、NeerⅢ型17例、NeerⅣ型17例，均采用锁定钢板治疗，比较不同Neer分型患者临床疗效、手术指标、并发症发生率、疼痛（VAS）评分、肩关节功能Constant-Murley评分以及不同Neer分型肱骨近端骨折与临床疗效、生物力学恢复情况的相关性。结果 NeerⅡ型骨折恢复优良率（94.44%）高于NeerⅢ型（88.24%）、NeerⅣ型（76.47%），且NeerⅢ型高于NeerⅣ型（P＜0.05）；NeerⅡ型术中出血量、骨折愈合时间均小于NeerⅢ型、NeerⅣ型，且NeerⅢ型小于NeerⅣ型（P＜0.05）；NeerⅡ型、NeerⅢ型、NeerⅣ型手术时间、术后并发症发生率比较，差异无统计学意义（P＞0.05）；NeerⅡ型术后VAS评分小于NeerⅢ型、NeerⅣ型，且NeerⅢ型小于NeerⅣ型（P＜0.05）；NeerⅡ型Constant-Murley评分高于NeerⅢ型、NeerⅣ型，且NeerⅢ型高于NeerⅣ型（P＜0.05）；Pearson相关性分析显示，Neer分型与临床疗效呈负相关（r=-0.425，P=0.001），与术中出血量、骨折愈合时间呈正相关（r=0.894、0.789，P=0.006、0.001），与Constant-Murley评分无相关性（r=-0.008，P=0.583）。结论 锁定钢板治疗不同Neer分型肱骨近端骨折均具有一定的疗效，但是Neer分型越高临床疗效越低，生物力学恢复、并发症发生率方面无显著差异。而损伤基础直接影响了术中出血量、骨折愈合时间及Constant-Murley肩关节功能评分情况，临床应依据损伤基础给予相应术后康复治疗，以提高肩关节恢复优良率。
Abstract:
Objective To observe the effect and biomechanical recovery of locking plate in the treatment of different Neer types of proximal humeral fractures.Methods A total of 52 patients with proximal humeral fractures treated in our hospital from June 2020 to June 2021 were selected as study subjects, including 18 patients with Neer type Ⅱ, 17 patients with Neer type Ⅲ, and 17 patients with Neer type Ⅳ. All patients were treated with locking plate. The clinical efficacy, surgical indicators, complication rate, pain (VAS) score, Constant-Murley score of shoulder joint function, and the correlation between different Neer types of proximal humeral fractures and clinical efficacy and biomechanical recovery were compared.Results The excellent and good rate of Neer type Ⅱ fracture recovery (94.44%) was higher than that of Neer type Ⅲ (88.24%) and Neer type Ⅳ (76.47%), and Neer type Ⅲ was higher than that of Neer type Ⅳ (P<0.05). The intraoperative blood loss and fracture healing time of Neer type Ⅱ were less than those of Neer type Ⅲ and Neer IV, and those of Neer type Ⅲ were less than those of Neer type Ⅳ (P<0.05). There was no significant difference in the operation time and incidence of postoperative complications among Neer type Ⅱ, Neer type Ⅲ and Neer type Ⅳ (P>0.05). The postoperative VAS score of Neer type Ⅱ was lower than that of Neer type Ⅲ and Neer type Ⅳ, and that of Neer type Ⅲ was lower than that of Neer type Ⅳ(P<0.05). The Constant-Murley score of Neer type Ⅱ was higher than that of Neer type Ⅲ and Neer type Ⅳ, and Neer type Ⅲ was higher than that of Neer type Ⅳ(P<0.05). Pearson correlation analysis showed that Neer classification was negatively correlated with clinical efficacy (r=-0.425, P=0.001), positively correlated with intraoperative blood loss and fracture healing time (r=0.894, 0.789, P=0.006, 0.001), and had no correlation with Constant-Murley score (r=-0.008, P=0.583).Conclusion Locking plate is effective in the treatment of proximal humeral fractures with different Neer types, but the higher the Neer type is, the lower the clinical effect is. There is no significant difference in biomechanical recovery and complication rate. The injury basis directly affects the intraoperative blood loss, fracture healing time and Constant-Murley shoulder function score. Clinically, the corresponding postoperative rehabilitation treatment should be given according to the injury basis to improve the excellent and good rate of shoulder joint recovery.

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更新日期/Last Update: 1900-01-01