潘海棠 1夏进先 1田红春 1祝茂松 1宋虎 1刘树沛1
作者信息
- 1. 孝感市第一人民医院骨科,湖北 孝感,432000
- 折叠
摘要
Abstract
Objective To explore the difference in therapeutic effect of two different exposure methods for proximal humeral fractures through the anterior approach of the shoulder joint.Methods The data of 47 cases of proximal humeral fractures treated in our department from April 2018 to March 2020 were retrospectively analyzed,using the anterior approach of shoulder joint.The deltoid space of the pectoralis major muscle was used in 26 cases,with an average age of(62.5±2.2)years.According to Neer's classification,there were 4 cases in the second part,9 cases in the third part,and 13 cases in the fourth part;and the other entered into the deltoid muscle space in 21 cases,from about 0.5-1.0 cm outside the front edge of the deltoid muscle,with an average age of(61.3±2.2)years.According to Neer's classification,there were 4 cases in the second part,7 cases in the third part,and 10 cases in the fourth part.The operation time,intraoperative blood loss,healing time,shoulder joint function score,pain score and postoperative complications of the two different exposure methods were compared.Results All 47 patients were followed up for 10-25 months,with an average of(15.6±4.7)months,all fractures healed in the first stage.There was no statistically significant difference in surgical time,intraoperative bleeding,and healing time between the deltoid muscle space of pectoralis major muscle group and the deltoid muscle space group(P>0.05).The last follow-up Constant-Murley score was(81.2±1.5)points in the deltoid muscle space of pectoralis major muscle group and(79.4±2.1)points in the deltoid muscle space group,there was a statistically significant difference between the two groups(P<0.05),the shoulder joint function of the deltoid muscle space of pectoralis major muscle group was better than that of the deltoid muscle space group.There was no statistically significant difference between the deltoid muscle space of pectoralis major muscl group and the deltoid muscle space group in the last follow-up VAS score(P>0.05).There was 1 postoperative complication in the deltoid muscle space of pectoralis major muscle group and 7 complications in the deltoid muscle space group,with a statistically significant difference(P<0.05),there was a higher incidence of postoperative complication in the deltoid muscle space group,which affected the surgical efficacy.The exposure of the deltoid muscle space of pectoralis major muscle group was satisfactory and did not damage the deltoid muscle.The deltoid muscle space group had some difficulties when it needed better exposure of the shoulder swelling,and the front deltoid muscle might be broken during the traction process,affecting the forward flexion and lifting function of the shoulder.Conclusion The exposure of the deltoid space between the pectoralis major muscle is more thorough than the exposure of the deltoid split muscle,resulting in less damage to the deltoid muscle and more satisfactory recovery of shoulder joint function.关键词
肱骨近端骨折/骨折内固定/手术显露方式Key words
Proximal humeral fracture/Internal fixation/Surgical exposure method分类
临床医学
