[摘要] 目的 探討內(nèi)側(cè)柱支撐重建術(shù)對(duì)肱骨近端骨折的臨床效果及對(duì)關(guān)節(jié)功能的改善作用。方法 方便選取2013年6月—2017年6月在該院接受肱骨近骨端手術(shù)患者100例，根據(jù)手術(shù)方法不同分為研究組50例和對(duì)照組50例。觀察患者術(shù)后骨折部位恢復(fù)情況，關(guān)節(jié)活動(dòng)度，肩關(guān)節(jié)上舉、外翻角度以及肱骨頭內(nèi)翻角度和肱骨頸干角度。結(jié)果 研究組患者住院時(shí)間（7.58±1.42）d、骨折部位痊愈時(shí)間（57.89±10.89）d、完全康復(fù)時(shí)間（85.89±17.67）d患者均顯著小于對(duì)照組（P<0.05）。術(shù)后，研究組患者的肘關(guān)節(jié)（96.80±10.67）分和肩關(guān)節(jié)功能（85.54±9.36分）、Neer評(píng)分（78.57±8.35）分均高于對(duì)照組患者，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。且術(shù)后肩關(guān)節(jié)上舉（109.34±9.45）°、外翻角度（24.46±3.67）°大于對(duì)照組患者，肱骨頭內(nèi)翻角度（1.27±0.24）°和肱骨頸干角度（2.56±0.68）°均小于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 內(nèi)側(cè)柱支撐重建術(shù)對(duì)肱骨近端骨折具有較好的臨床效果，能夠促進(jìn)關(guān)節(jié)功能恢復(fù)。
　　[關(guān)鍵詞] 內(nèi)側(cè)柱支撐肱骨；近端骨折；關(guān)節(jié)功能
　　[中圖分類(lèi)號(hào)] R274 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2018）01（c）-0006-03
　　[Abstract] Objective This paper tries to study the clinical effect of reconstructing the medial column support in treating the proximal humerus fracture and its effect in improving the function of patients’ joint. Methods 100 patients treated in this department from June 2013 to June 2017 were conveient selected. And equally divided into study group and control group， according to different therapeutic method. And the recovery of postoperative in fracture site， the activity of the joints， the rotation angle of the shoulder ， and the angle of the humeral head and the humerus neck were observed. Results The time of hospitalization （7.58±1.42）d， the recovery time of fracture site（57.89±10.89）d and the complete recovery time （85.89±17.67）d were significantly lower than those of the control group （P<0.05）. After surgery， the elbow （96.80±10.67）points and shoulder function （85.54±9.36）points and Neer score（78.57±8.35）points were significantly higher in the study group than those in the control group （P<0.05）. The shoulder lift after surgery（109.34±9.45）° and the valgus angle （24.46±3.67）° was higher than that of the control group. Humerus head varus angle（1.27±0.24）° and the angle of humeral neck（2.56±0.68）° were lower than those of the control group， and there was significant difference（P<0.05）. Conclusion The clinical effect of reconstructing the medial column support in treat the proximal humerus fracture is better， and can promote the recovery of joint’s function.
　　[Key words] The medial column supports the humerus； Proximal fracture； Joint function
　　近年來(lái)由于我國(guó)人口老齡化，該部位骨折在骨質(zhì)疏松的中老年患者中較為普遍[1]。對(duì)于肱骨近端粉碎性骨折和移位較重的中老年患者，目前在治療上比較棘手[2-3]。肱骨近端鎖定接骨板（locking proximal humeral plate，LPHP），由于對(duì)機(jī)體軟組織損傷較小、固定可靠和把持力強(qiáng)等優(yōu)點(diǎn)，在臨床上應(yīng)用日漸廣泛[4]。有研究表明，肱骨近端骨折的手術(shù)中，恢復(fù)肱骨近端內(nèi)側(cè)柱的完整性，能夠有效維持骨折復(fù)位、避免內(nèi)固定失敗和防止復(fù)位后高度丟失[5-6]。因此，該文方便選取2013年6月—2017年6月在該院接受肱骨近骨端手術(shù)患者100例，來(lái)探究?jī)?nèi)側(cè)柱支撐重建術(shù)對(duì)肱骨近端骨折的臨床效果及對(duì)關(guān)節(jié)功能的改善作用。
　　1 資料與方法

相關(guān)熱詞搜索：肱骨 骨折 關(guān)節(jié) 重建 臨床