治疗肱骨大粗隆孤立骨折的三种手术方法比较研究

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Therapeutics and Clinical Risk Management Pub Date : 2024-08-09 DOI:10.2147/tcrm.s455379
Fulin Tao, Lin Li, Dawei Wang, Jinlei Dong, Dongsheng Zhou, Wenhao Song
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引用次数: 0

摘要

简介本研究旨在比较三种方法治疗孤立性肱骨大结节骨折的疗效:对我院2013年1月至2021年6月期间的孤立性肱骨大结节骨折患者进行回顾性研究。我们记录了患者的人口统计学特征、损伤特征、术前和术后影像学检查结果、切口长度、手术时间和术中失血量等数据:共有 107 名患者符合纳入标准,并被分为三组。A组50名患者使用肱骨近端内固定系统(PHILOS)钢板,采用胸骨正中切口固定;B组26名患者使用肱骨近端内固定系统(PHILOS)钢板,采用三角肌分割切口固定;C组31名患者使用新型解剖钢板,采用三角肌分割切口固定。两组患者在性别、年龄、受伤机制、骨折类型、优势侧肢体或肩关节前脱位方面均无明显差异。然而,C 组的手术时间、失血量和切口长度均短于C 组。此外,对术后第三天和第五天的疼痛进行了评估,C 组的疼痛较轻,最后一次随访时的疼痛在两组间无差异。在 Constant 评分、DASH 评分和最后一次随访时的 ROM 方面没有发现明显差异。2名患者被诊断为肩峰下撞击,A组1名,B组1名,B组1名患者术后出现腋神经损伤:结论:采用三角肌劈裂法固定的新型解剖钢板在治疗孤立性肱骨大结节骨折时能取得良好的效果,且失血少、手术时间短、手术切口小,并能缓解术后早期疼痛:PHILOS 钢板(一种新型解剖钢板)、胸骨外侧入路、三角肌劈裂入路、肱骨大结节骨折
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Comparison Study Among Three Surgical Methods in the Treatment of Isolated Fractures of the Greater Tuberosity of the Humerus
Introduction: This study aimed to compare the efficacy of three methods for isolated greater tuberosity fractures of the humerus.
Methods: A retrospective review of patients with isolated humeral greater tuberosity fractures between January 2013 and June 2021 in our institution. We recorded data on patient demographics, injury characteristics, preoperative and postoperative imaging findings, length of incision, operative time, and intraoperative blood loss.
Results: A total of 107 patients met the inclusion criteria and were divided into three groups. 50 patients in group A were administered a proximal humeral internal locking system (PHILOS) plate fixed using the deltopectoral approach, 26 patients in group B were administered a PHILOS plate fixed using the deltoid-splitting approach, and 31 patients in group C were administered a novel anatomical plate fixed using the deltoid-splitting approach. No significant differences were identified in sex, age, injury mechanism, type of fracture, dominant side limb, or shoulder anterior joint dislocation. However, the operative time, blood loss, and the length of incision was shorter than in Group C. Moreover, pain was evaluated on the third and fifth days after surgery; pain was lower in Group C, and pain at the last follow-up was not different between the groups. No significant differences were identified in the Constant score, DASH score, and ROM at the last follow-up. 2 patients were diagnosed with subacromial impingement, 1 in Group A one in Group B, and 1 patient in Group B experienced axillary nerve injury after surgery.
Conclusion: The novel anatomical plate fixed using the deltoid-splitting approach can achieve good results in the treatment of isolated humeral greater tubercle fractures with less blood loss, shorter operative time, and shorter surgical incisions, and can relieve pain in the early postoperative period.

Keywords: PHILOS plate, a novel anatomical plate, deltopectoral approach, deltoid-splitting approach, greater tuberosity fracture of humerus
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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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