[1]唐萌芽,夏炳江,张沂,等.切开复位肱骨近端内固定锁定系统内固定 联合中药薰蒸治疗复杂肱骨近端骨折[J].中医正骨,2013,25(12):24-27.
　Tang Mengya*,Xia Bingjiang,Zhang Yi,et al.Clinical study on open reduction and internal fixation with proximal humeral internal locking system(PHILOS)combined with Chinese herbal steaming and washing therapy in the treatment of complicated proximal humeral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(12):24-27.
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切开复位肱骨近端内固定锁定系统内固定 联合中药薰蒸治疗复杂肱骨近端骨折()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年12期
页码:
24-27
栏目:
临床研究
出版日期:
2013-12-30

文章信息/Info

Title:
Clinical study on open reduction and internal fixation with proximal humeral internal locking system(PHILOS) combined with Chinese herbal steaming and washing therapy in the treatment of complicated proximal humeral fractures
作者:
唐萌芽1; 夏炳江2; 张沂1; 邵利芳1; 王国平1
1.浙江省富阳市中医骨伤医院,浙江 富阳 311400;
2.浙江中医药大学,浙江 杭州 310053
Author(s):
Tang Mengya*; Xia Bingjiang; Zhang Yi; Shao Lifang; Wang Guoping.*
Fuyang TCM Orthopedic-Traumatological Hospital,Fuyang 311400,Zhejiang,China
关键词:
肩骨折 肱骨骨折 骨折固定术; 内 薰洗 肱骨近端内固定锁定系统
Keywords:
Shoulder fractures;  Humeral fractures;  Fracture fixation; internal;  Steaming washing therapy;  Proximal humeral internal locking system
摘要:
目的:观察切开复位肱骨近端内固定锁定系统内固定配合中药薰蒸治疗复杂肱骨近端骨折的临床疗效。方法:将62例复杂 肱骨近端骨折患者随机分为观察组和对照组,每组31例。观察组采用切开复位肱骨近端内固定锁定系统内固定联合中药薰蒸治疗 ,对照组采用切开复位肱骨近端内固定锁定系统内固定治疗。记录并比较2组患者的骨折临床愈合时间,并于术后1年评价并比较2 组患者的Neer肩关节功能评分及其等级。结果:2组患者骨折临床愈合时间比较,差异无统计学意义[(13.9±4.2)周, (14.2±5.6)周,t=0.138,P=0.887]; 观察组Neer肩关节功能评分高于对照组[(87.3±4.2)分,(82.9±2.9) 分,t=2.735,P=0.014]。2组患者Neer肩关节功能评分等级比较,观察组优25例、良3例、可1例、差2例,对照组优17例、良8例、 可4例、差2例,观察组优于对照组(Z=-2.010,P=0.044)。结论:对于肱骨近端Neer三、四部分骨折患者而言,虽然切开复位肱骨近 端内固定锁定系统联合中药薰蒸与单纯切开复位肱骨近端内固定锁定系统在骨折愈合时间方面无明显差异,但切开复位肱骨近端 内固定锁定系统联合中药薰蒸能够明显缓解肩关节疼痛,改善肩关节功能,疗效确切,是治疗复杂肱骨近端骨折的一种较理想的方 法,值得临床推广应用。
Abstract:
Objective:To observe the clinical curative effect of open reduction and internal fixation with proximal humeral internal locking system(PHILOS)combined with Chinese herbal steaming and washing therapy in the treatment of complicated proximal humeral fractures.Methods:Sixty-two patients with complicated proximal humeral fractures were randomly divided into observation group and control group,31 cases in each group.Patients in the observation group were treated with open reduction and internal fixation with PHILOS combined with Chinese herbal steaming and washing therapy,while the others in the control group were merely treated with open reduction and internal fixation with PHILOS.The clinical fracture healing time were recorded and compared between the 2 groups,and the Neer shoulder performance score and grade were evaluated and compared between the 2 groups 1 year after operation.Results:There was no statistical difference in clinical fracture healing time between the 2 groups(13.9+/-4.2 vs 14.2+/-5.6 weeks,t=0.138,P=0.887).Neer shoulder performance scores of observation group were higher than that of control group(87.3+/-4.2 vs 82.9+/-2.9 points,t=2.735,P=0.014).Twenty-five patients obtained an excellent result,3 good,1 fair and 2 poor in the observation group,while 17 patients obtained an excellent result,8 good,4 fair and 2 poor in the control group.The observation group surpassed the control group in the grade of Neer shoulder performance score(Z=- 2.010,P=0.044).Conclusion:The combination therapy of open reduction and internal fixation with PHILOS combined with Chinese herbal steaming and washing has similar fracture healing time to the monotherapy of open reduction and internal fixation with PHILOS for 3-part and 4-part proximal humeral fractures.However,the combination therapy can alleviate the shoulder pain obviously and improve the shoulder function,and it is an ideal method for complicated proximal humeral fracture and worthy of popularizing in clinic.

参考文献/References:

[1] Mckoy BE,Bensen CV,Hartsock LA.Fractures about the shoulder:conservative management[J].Orthop Clin North Am,2000,31(2):205-216.
[2] Neer CS 2nd.Displaced proximal humeral fractures.Ⅰ.Classification and evaluation[J].J Bone Joint Surg Am,1970,52(6):1077-1089.
[3] Hintermann B,Trouillier HH,Sch?fer D.Rigid internal fixation of fractures of the proximal humerus in older patients[J].J Bone Joint Surg Br,2000,82(8):1107-1112.
[4] 中华医学会.临床诊疗指南:骨科分册[M].北京:人民卫生出版社,2009:15-16.
[5] 王亦璁.骨与关节损伤[M].4版.北京:人民卫生出版社,2007:756-768.
[6] 吴在德,吴肇汉.外科学[M].7版.北京:人民卫生出 版社,2008:728-729.
[7] Robinson CM,Amin AK,Godley KC,et al.Modern perspectives of open reduction and plate fixation of proximal humerus fractures[J].J Orthop Trauma,2011,25(10):618-629.
[8] 吴星火,杨述华,张劲松,等.经皮穿针和逆行髓内针固定治疗肱骨近端骨折[J].中国微创外科杂志,2007,7(2):171-173.
[9] 滕范文,赵云芳,王淑和,等.闭合复位空心钉与T型钢板治疗复杂肱骨近端骨折的疗效比较[J].中国骨与关节损伤杂 志,2008,23(9):762-763.
[10] 胡稷杰,金丹,王钢,等.肱骨近端锁定接骨板/肱骨近端内锁定系统和人工肱骨头置换治疗成年人肱骨近端骨折的疗效比较 [J].中国骨与关节外科,2012(5):394-400.
[11] 潘烈,刘卫清,张海兵,等.肱骨近端内锁定系统治疗肱骨近端骨折[J].临床骨科杂志,2010,13(4):412-413.
[12] 龙炳新.中药熏洗配合手法按摩治疗创伤性肘关节僵硬83例[J].中国中医骨伤科杂志,2003,11(6):50-51.
[13] 李伟,张增田,张涛.牵引下正骨加中药熏蒸治疗颈椎间盘突出症50例[J].按摩与导引,2006,22(3):32-33.
[14] 刘芹芳.中药薰蒸加奇经疗法治疗肩周炎50例的护理[J].解放军护理杂志,2006,23(11):70-71.

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备注/Memo

备注/Memo:
2012-12-22收稿 2013-02-26修回
更新日期/Last Update: 2013-12-30