[1]李卫国,孙献武,谭训香,等.闭合复位内外固定结合中医康复治疗肱骨近端骨折的临床研究[J].中医正骨,2016,28(05):1-4.
　LI Weiguo,SUN Xianwu,TAN Xunxiang,et al.Clinical study on closed reduction and internal & external fixation combined with TCM rehabilitation in the treatment of proximal humeral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(05):1-4.
点击复制

闭合复位内外固定结合中医康复治疗肱骨近端骨折的临床研究()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年05期
页码:
1-4
栏目:
临床研究
出版日期:
2016-05-20

文章信息/Info

Title:
Clinical study on closed reduction and internal & external fixation combined with TCM rehabilitation in the treatment of proximal humeral fractures
作者:
李卫国; 孙献武; 谭训香; 刘双双
山东省文登整骨医院,山东 文登 264400
Author(s):
LI Weiguo; SUN Xianwu; TAN Xunxiang; LIU Shuangshuang
The Wendeng Osteopath Hospital,Wendeng 264400,Shandong,China
关键词:
肱骨骨折;  肩骨折;  骨折固定术;  中医康复;  临床试验
Keywords:
humeral fractures;  shoulder fractures;  fracture fixation;  rehabilitation(TCM);  clinical trial
摘要:
目的:观察闭合复位内外固定结合中医康复治疗肱骨近端骨折的临床疗效。方法:将符合要求的87例肱骨近端骨折患者随机分为2组,行闭合复位内外固定术,术后分别采用中医康复和常规康复治疗。随访观察2组患者的骨折愈合时间及肩关节功能恢复时间,并于治疗20周后采用Constant-Murley肩关节评分标准评定疗效。结果:所有患者均获随访,随访时间8～18个月,中位数14个月。中医康复组的骨折愈合时间及肩关节功能恢复时间均短于常规康复组[(11.94±1.20)周,(13.02±1.64)周,t=2.790,P=0.007;(15.80±2.11)周,(17.47±2.14)周,t=3.664,P=0.000]。Constant-Murley肩关节评分中,中医康复组的疼痛评分低于常规康复组[(4.60±1.12)分,(5.40±1.14)分,t=3.239,P=0.002],日常活动评分及关节活动范围评分高于常规康复组[(15.70±2.24)分,(14.64±1.90)分,t=2.362,P=0.020;(30.76±3.65)分,(28.47±4.23)分,t=2.714,P=0.008],而2组肌力评分比较,差异无统计学意义(t=1.628,P=0.107)。结论:对肱骨近端骨折实施闭合复位内外固定后采用中医康复治疗,骨折愈合快,肩关节功能恢复好,值得临床推广应用。
Abstract:
Objective:To observe the curative effect of closed reduction and internal & external fixation combined with TCM rehabilitation in the treatment of proximal humeral fractures.Methods:Eighty-seven patients with proximal humeral fractures enrolled in the study were randomly divided into 2 groups,and were treated with closed reduction and internal & external fixation.After the surgery,the patients were treated with TCM rehabilitation(TCM rehabilitation group)and conventional rehabilitation(conventional rehabilitation group)respectively.The patients were followed up,and the fracture healing time and the shoulder function recovery time were observed and compared between the 2 groups.After 20-week treatment,the curative effect was evaluated by using Constant-Murley shoulder joint scoring criterion.Results:The patients in the 2 groups were followed up for 8-18 months with a median of 14 months.The fracture healing time and the shoulder function recovery time were shorter in TCM rehabilitation group compared to conventional rehabilitation group(11.94+/-1.20 vs 13.02+/-1.64 weeks,t=2.790,P=0.007; 15.80+/-2.11 vs 17.47+/-2.14 weeks,t=3.664,P=0.000).The Constant-Murley shoulder pain scores were lower in TCM rehabilitation group compared to conventional rehabilitation group(4.60+/-1.12 vs 5.40+/-1.14 points,t=3.239,P=0.002).The Constant-Murley shoulder daily activity scores and joint motion range scores were higher in TCM rehabilitation group compared to conventional rehabilitation group(15.70+/-2.24 vs 14.64+/-1.90 points,t=2.362,P=0.020; 30.76+/-3.65 vs 28.47+/-4.23 points,t=2.714,P=0.008).There was no statistical difference in muscle strength scores between the 2 groups(t=1.628,P=0.107).Conclusion:Short fracture healing time and good shoulder function can be obtained by using TCM rehabilitation in patients with proximal humeral fractures after closed reduction and internal & external fixation.

参考文献/References:

[1] Neer CS 2nd.Displaced proximal humeral fractures.Ⅰ.Classification and evaluation[J].J Bone Joint Surg Am,1970,52(6):1077-1089.
[2] 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,2008:15-16.
[3] 王亦璁.骨与关节损伤[M].4版.北京:人民卫生出版社,2007:763.
[4] Constant CR,Gerber C,Emery RJ,et al.A review of the Constant score:modifications and guidelines for its use[J].J Shoulder Elbow Surg,2008,17(2):355-361.
[5] Court-Brown CM,Caesar B.Epidemiology of adult fractures:a review[J].Injury,2006,37(8):691-697.
[6] 钱平康,徐锋,孙斌峰,等.肱骨近端内锁定系统固定结合植骨治疗肱骨近端骨折[J].中医正骨,2015,27(9):36-37.
[7] 檀少强.经皮空心螺钉固定及康复训练治疗老年肱骨近端骨折疗效观察[J].现代中西医结合杂志,2012,21(1):52-53.
[8] 党洪胜,陈占峰,杜娴,等.肩关节周围骨折及术后肱骨头向下半脱位的临床分析[J].中国骨与关节损伤杂志,2010,25(7):589-591.
[9] Kumar VP,Balasubramaniam P.The role of atmospheric pressure in stabilising the shoulder.An experimental study[J].J Bone joint surg Br,1985,67(5):719-721.
[10] Dudko S,Wojciechowski P,Kusz D,et al.Inferior subluxation of humerus after surgery of fractures of proximal humerus[J].Chir Narzadow Ruchu Ortop Pol,2002,67(2):175-180.
[11] 彭力平,林松青,陈浩雄.肩肘弹力带固定结合练功疗法治疗外伤性肩关节松弛症临床对照试验[J].中国骨伤,2008,21(7):503-505.
[12] 白跃宏.骨科康复研究进展与展望[J].中国矫形外科杂志,2013,21(9):849.
[13] 张庆宇,东靖明,李奇,等.早期康复训练对肱骨远端骨折术后患者功能恢复的影响[J].中国矫形外科杂志,2013,21(22):2255-2259.
[14] 罗玉君.手法松解术后超早期功能锻炼治疗肩关节周围炎的疗效观察[J].中医正骨,2014,26(5):21-22.
[15] 郭振业,段王平,卫小春.骨化性肌炎的研究新进展[J].实用骨科杂志,2013,19(7):629-632.
[16] Liu G,Kawaguchi H,Ogasawara T,et al.Optimal combination of soluble factors for tissue engineering of permanent cartilage from cultured human chondrocytes[J].J Boil Chem,2007,282(28):20407-20415.
[17] 赵卫侠,刘波,张鑫,等.综合康复疗法治疗上肢骨折术后肘关节功能障碍[J].中医正骨,2014,26(9):36-38.
[18] Shibuya N,Schinke TL,Canales MB,et al.Effect of cryotherapy devices in the postoperative setting[J].J Am Podiatr Med Assoc,2007,97(6):439-446.

相似文献/References:

[1]朱峰,宋相建,吴蔚,等.手法复位经皮克氏针内固定治疗 儿童闭合性肱骨远端全骨骺分离[J].中医正骨,2015,27(11):51.
[2]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(05):1.
[3]唐剑邦,吴宇峰,高大伟,等.切开复位肱骨近端锁定钢板内固定治疗 陈旧性肩关节后脱位合并肱骨近端骨折[J].中医正骨,2015,27(10):49.
[4]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(05):22.
[5]刘昕,邓志强,叶家军.大龄儿童肱骨外髁陈旧性骨折不愈合继发肘外翻畸形的 分期手术治疗[J].中医正骨,2015,27(07):55.
[6]江涛,江林,史俊德.逆转推压法复位克氏针内固定治疗小儿肱骨外髁Ⅲ型骨折[J].中医正骨,2015,27(12):60.
[7]王海敏,汤志刚,诸葛天瑜,等.桥接组合式内固定系统固定治疗肱骨远端骨折[J].中医正骨,2015,27(12):63.
[8]蒋健,杨晓.尺侧小切口复位结合经皮交叉克氏针内固定 治疗儿童肱骨髁上骨折[J].中医正骨,2015,27(02):60.
[9]彭玉兰,周英,王英.分步手法复位肘关节外翻位固定联合外用中药治疗 婴幼儿肱骨髁上骨折[J].中医正骨,2015,27(04):56.
[10]曹进,胡珊珊,郑华江,等.闭合复位弹性髓内钉内固定与切开复位锁定加压钢板 内固定治疗青少年肱骨干骨折的疗效比较[J].中医正骨,2015,27(01):9.
　CAO Jin,HU Shanshan,ZHENG Huajiang,et al.A clinical comparison of closed reduction and elastic stable intramedullary nail internal fixation versus open reduction and locking compression plate internal fixation for treatment of humeral shaft fractures in adolescents[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(05):9.
[11]钱平康,徐锋,孙斌峰,等.肱骨近端内锁定系统固定结合植骨治疗肱骨近端骨折[J].中医正骨,2015,27(09):36.
[12]姜自伟,欧阳崇志,黄枫,等.肱骨近端骨折改良Neer分型的四部评分法[J].中医正骨,2015,27(09):64.
[13]余斌峰,王伟良,林锡鹏.加长型肱骨近端内固定锁定系统治疗肱骨干骨折 合并同侧肱骨近端骨折[J].中医正骨,2015,27(08):23.
[14]孙旗,姜孟家,王淑斌,等.针刺疗法预防肱骨近端骨折内固定术后肩关节功能障碍的临床研究[J].中医正骨,2016,28(04):29.
　SUN Qi,JIANG Mengjia,WANG Shubin,et al.A clinical study of acupuncture therapy for prevention of shoulder dysfunction after internal fixation of proximal humeral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(05):29.
[15]戴喜安,梁卫东,曾志奎,等.3D打印技术辅助下切开复位跟骨锁定钢板内固定治疗劈裂型肱骨大结节骨折[J].中医正骨,2022,34(06):69.

更新日期/Last Update: 2016-10-30