[1]孙晓,张玉柱,王国平,等.手法复位杉树皮夹板固定治疗肱骨近端骨折的 临床疗效观察[J].中医正骨,2012,24(07):13-16.
　SUN Xiao*,ZHANG Yu-zhu,WANG Guo-ping,et al.Observation on the clinical curative effect of manipulative reduction combined with Chinese fir-bark splint fixation in the treatment of proximal humeral fracture[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(07):13-16.
点击复制

手法复位杉树皮夹板固定治疗肱骨近端骨折的 临床疗效观察()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期数:
2012年07期
页码:
13-16
栏目:
临床研究
出版日期:
2012-07-30

文章信息/Info

Title:
Observation on the clinical curative effect of manipulative reduction combined with Chinese fir-bark splint fixation in the treatment of proximal humeral fracture
作者:
孙晓1; 张玉柱1; 王国平1; 周辉2; 王蕾3; 张剑英1; 张 姚萍1; 刘剑斌1; 李振1
1.浙江省富阳市中医骨伤医院,浙江 富阳 311400;
2.浙江省杭州市中医院, 浙江 杭州 310000;
3.上海交通大学医学院附属瑞金医院,上海 200025
Author(s):
SUN Xiao*; ZHANG Yu-zhu; WANG Guo-ping; ZHOU Hui; WANG Lei; ZHANG Jian-ying; ZHANG Yao-ping; LIU Jian-bin; LI Zhen.*
TCM Orthopaedics Hospital of Fuyang City,Fuyang 311400,Zhejiang,China
关键词:
肩骨折 肱骨骨折 小夹板固定 治疗; 临床研究性
Keywords:
Shoulder fractures;  Humeral fractures;  Small splint fixation;  Therapies; investigational
摘要:
目的:观察手法复位杉树皮夹板固定治疗肱骨近端骨折的临床疗效。方法:将60例肱骨近端骨折患者分成外固定组和内固 定组,每组30例。外固定组患者采用富阳张氏手法复位配合杉树皮夹板固定治疗,内固定组患者采用切开复位钢板内固定治疗。 治疗后分别从复位情况、骨折愈合时间、Constant-Murley评分及患者满意度4个方面评价2组患者的临床疗效。结果:①骨折复 位情况。内固定组骨折复位情况优于外固定组(Z=-3.850,P=0.000)。②骨折愈合时间。外固定组所有患者骨折均愈合,内固定组 1例未愈合,继发肱骨头坏死。外固定组骨折愈合时间比内固定组短(t=0.872,P=0.018)。③肩关节功能。2组患者疼痛、日常生 活能力、肩关节活动度、肌力及Constant-Murley总分比较,差异均无统计学意义(t=1.091,P=0.081; t=0.982,P=0.166; t=1.542,P=0.098; t=2.146,P=0.541; t=3.466,P=0.167)。④患者满意度。外固定组患者满意度高于内固定组(Z=- 4.452,P=0.000)。结论:采用手法复位杉树皮夹板固定治疗肱骨近端骨折可以获得与钢板内固定治疗相当的疗效,而且骨折愈合 时间短、患者满意度更高,值得在临床推广应用。
Abstract:
Objective:To observe the clinical curative effect of manipulative reduction combined with Chinese fir-bark splint fixation in the treatment of proximal humeral fracture(PHF).Methods:Sixty PHF patients were divided into external fixation group and internal fixation group,30 cases in each group.Patients in the external fixation group were administrated with Fuyang Zhang's manipulative reduction combined with Chinese fir-bark splint fixation,while the others in the internal fixation group were administrated with open reduction and internal fixation.After the treatment,the clinical curative effects of the patients in the 2 groups were evaluated from the 4 aspects as reduction state,fracture healing time,Constant-Murley scores and patient satisfaction respectively.Results:①Fracture reduction state of internal fixation group was better than that of external fixation group(Z=-3.850,P=0.000).②Fractures of all the patients in the external fixation group were all healed,while 1 case with unhealed fracture and secondary humeral head necrosis was found in internal fixation group.Fracture healing time of external fixation group was shorter than that of internal fixation group(t=0.872,P=0.018).③There was no statistical difference in the aspects of pain,daily living ability,shoulder joint motion,muscle strength and Constant-Murley total scores between the 2 groups (t=1.091,P=0.081; t=0.982,P=0.166; t=1.542,P=0.098; t=2.146,P=0.541; t=3.466,P=0.167).④Patient satisfaction of external fixation group was higher than that of internal fixation group(Z=-4.452,P=0.000).Conclusion:With shorter fracture healing time and higher patient satisfaction,manipulative reduction combined with Chinese fir-bark splint fixation has the similar curative effect to that of open reduction and internal fixation in PHF treatment,and it is worth popularizing in the clinics.

参考文献/References:

[1] 姜保国,张殿英,付中国.肱骨近端骨折的治疗建议[J].中华创伤骨科杂志,2011,13(1):55-59.
[2] Neer CS 2nd.Displaced proximal humeral fractures.I.Classification and evaluation[J].J Bone Joint Surg Am,1970,52(6):1077-1089.
[3] 国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:163.
[4] Constant CR,Murley AH.A clinical method of functional assessment of the shoulder[J].Clin Orthop Relat Res,1987,(214):160-164.
[5] 孔德奇,朱文雄,李健,等.二、三部分肱骨近端移位骨折的手术治疗[J].中华创伤骨科杂志,2003,5(1):29-31.
[6] 陆晴友,王秋根,张秋林,等.肱骨近端骨折的手术治疗[J].中华创伤骨科杂志,2003,4(4):316-319.
[7] 孙晓,王国平,孙玉明.老年肱骨近端复杂骨折治疗方法的选择[J].中医正骨,2006,18(12):21-22.
[8] 王兴中,何维英.手法整复竹夹板外固定治疗肱骨近端骨折[J].中医正骨,2011,23(3):13-15.
[9] Kollig E,Kutscha-Lissberg F,Roetman B,et al.Complex fractures of the humeral head:which long-term results can be expected?[J].Zentralbl Chir,2003,128(2):111-118.
[10] 姜春岩,耿向苏,王满宜,等.人工肩关节置换治疗复杂肱骨近端骨折[J].中华外科杂志,2001,39(11):887-890.
[11] 马印来,傅伟,魏玉良.两种方式治疗肱骨近端骨折疗效分析[J].中医正骨,2007,19(11):44-45.
[12] 张作君.对肱骨近端骨折治疗的几点看法[J].中医正骨,2011,23(10):30-33.

相似文献/References:

[1]孙献武,于香兰,邵海燕,等.应用三维动静态平衡康复模式治疗 非脊髓型颈椎病的临床研究[J].中医正骨,2015,27(11):8.
　SUN Xianwu,YU Xianglan,SHAO Haiyan,et al.Clinical study on three-dimensional dynamic and static equilibrium rehabilitation modality in the treatment of non-myelopathy type cervical spondylosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):8.
[2]宁兴明,伍亮,王廷,等.五禽戏配合核心肌力训练治疗非特异性腰痛的临床研究[J].中医正骨,2015,27(11):25.
　NING Xingming,WU Liang,WANG Ting,et al.Clinical study on five mimic-animal boxing combined with core muscular strength exercise for the treatment of nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):25.
[3]沈海,刘昕,彭玉兰,等.复位架牵引下手法复位经皮穿针内固定治疗 儿童肱骨髁上骨折的临床研究[J].中医正骨,2015,27(10):1.
　SHEN Hai,LIU Xin,PENG Yulan,et al.Clinical study on reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation for treatment of humeral supracondylar fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):1.
[4]葛波涌,王玉波,王明太,等.交锁髓内钉内固定治疗胫骨干骨折的临床研究[J].中医正骨,2015,27(10):8.
　GE Boyong,WANG Yubo,WANG Mingtai,et al.Clinical study on the internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):8.
[5]梁朝,蔡静怡,闫立,等.针刀疗法改善膝骨关节炎早期疼痛症状的疗效评价[J].中医正骨,2015,27(09):9.
　LIANG Zhao,CAI Jingyi,YAN Li,et al.Evaluation of the curative effect of needle-knife therapy for relieving knee pain in patients with early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):9.
[6]邢金明.切开复位锁定钢板内固定术和人工半肩关节置换术 治疗老年肱骨近端复杂骨折的对比研究[J].中医正骨,2015,27(08):11.
　XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):11.
[7]帅波,沈霖,杨艳萍,等.加味青娥丸治疗膝骨关节炎的作用机制研究[J].中医正骨,2015,27(07):15.
　SHUAI Bo,SHEN Lin,YANG Yanping,et al.Study on the mechanism of action of Jiawei Qing'e Wan(加味青娥丸)for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):15.
[8]黄杨,王昌兴,邹阳.AO钛制弹性髓内钉内固定与切开复位钢板内固定治疗 小儿肱骨干中下段骨折的比较研究[J].中医正骨,2015,27(07):22.
　HUNAG Yang,WANG Changxing,ZOU Yang.A comparative study of AO titanium elastic stable intramedullary nail internal fixation versus open reduction plate osteosynthesis for the treatment of mid-distal humeral fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):22.
[9]梅其杰,袁长深,段戡,等.壮药骨痹方烫熨联合运动疗法治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):27.
　MEI Qijie,YUAN Changshen,DUAN Kan,et al.Clinical study of the curative effect of hot compressing and rubbing with packet of Gubi Fang(骨痹方)combined with exercise therapy in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):27.
[10]王丹辉,张燕,刘丽娟,等.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白 关节腔注射联合中药薰洗治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):31.
　WANG Danhui,ZHANG Yan,LIU Lijuan,et al.Clinical study on intra-articular injection of TypeⅡrecombinant human tumor necrosis factor receptor-Fc fusion protein combined with Chinese herbal steaming and washing therapy for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):31.

备注/Memo

备注/Memo:
2011-12-14收稿 2012-05-29修回
基金项目:浙江省杭州市医疗科研及重点专病专科项目 (20091233B32)
通讯作者:孙晓 E-mail:fygssx@sina.com
更新日期/Last Update: 2012-07-30