梁善校

【摘要】 目的：比較可吸收螺钉和肱骨近端解剖型钢板内固定治疗肱骨大结节撕脱性骨折的临床效果、安全性及患者的预后。方法：选取105例肱骨大结节撕脱性骨折患者，随机分为A组（55例，采用可吸收螺钉）和B组（50例，采用肱骨近端解剖型钢板），分析比较两组患者的治疗效果。结果：两组手术时间比较差异无统计学意义（P>0.05）；A组出血量为（206.3±44.5）ml，少于B组的（378.6±54.2）ml；A组住院时间为（10.2±2.2）d，短于B组的（17.5±3.6）d；A组骨折愈合时间为（36.5±6.5）d，短于B组的（48.5±7.6）d；A组Constant评分为（90.9±6.6）分，高于B组的（75.9±5.8）分；A组ASES评分为（89.2±3.7）分，高于B组的（70.0±2.2）分；A组并发症发生率为3.8%，低于B组的 16.0%。A组各指标均优于B组，差异均有统计学意义（P<0.05）。结论：可吸收螺钉治疗有效，安全性高，术中出血量少，术后并发症发生率低，患者住院时间、骨折愈合时间均较短，可作为肱骨大结节撕脱性骨折的有效手术方案。

【关键词】 可吸收螺钉； 解剖型钢板； 内固定； 肱骨大结节撕脱性骨折

doi：10.14033/j.cnki.cfmr.2018.1.012 文献标识码 B 文章编号 1674-6805（2018）01-0025-02

Clinical Comparative Study of Absorbable Screw and Proximal Humerus Anatomical Plate Internal Fixation in Treatment of Avulsion Fracture of Greater Tuberosity of Humerus/LIANG Shanxiao.//Chinese and Foreign Medical Research，2018，16（1）：25-26

【Abstract】 Objective：To compare the clinical efficacy，safety and the prognosis of patients of absorbable screw and proximal humerus anatomical plate internal fixation in treatment of avulsion fracture of greater tuberosity of humerus.Method：A total of 105 patients with avulsion fracture of greater tuberosity of humerus were randomly into group A（n=55，treated with absorbable screw） and group B（n=50，treated with proximal humerus anatomical plate internal fixation）.The clinical efficacy，safety and the prognosis of patients were compared between the two groups.Result：There was no statistically significant difference of the operation time between two groups（P>0.05）.The amount of bleeding in group A was（206.3±44.5）ml，less than （378.6±54.2）ml of group B，the hospitalization time of group A was （10.2±2.2）d，shorter than （17.5±3.6）d of group B，the fracture healing time of group A was（36.5±6.5）d，shorter than （48.5±7.6）d of group B，the constant score of group A was （90.9±6.6） points，higher than （75.9±5.8） points of group B，the ASES score of group A was（89.2±3.7） points， higher than （70.0±2.2） points of group B，the complication incidence rate was 3.8% of group A，lower than 16.0% of group B.The indexes of group A were better than those of the group B，the differences were statistically significant（P<0.05）.Conclusion：The treatment of absorbable screw for avulsion fracture of greater tuberosity of humerus is better，with more safety and less blood loss，lower postoperative infection rate，shorter hospital stay，faster fracture healing.It is worthy of using as the effective surgical treatment of avulsion fracture of the humerus greater tuberosity.endprint

【Key words】 Absorbable screws； Anatomical plate； Internal fixation； Avulsion fracture of greater tuberosity of humerus

First-authors address：Baise Peoples Hospital，Baise 533000，China

肱骨大结节骨折是临床中较为常见的骨折，少数为单独发生，大多系肩关节前脱位时并发，其发生率约占10%[1-2]。文献[3]数据显示，30岁以下女性肱骨近端骨折发生率较男性更频繁，特别是在骨质疏松患者中。其中肱骨大结节骨折相对肱骨头、肱骨干、小结节骨折更为普遍，发生率达30%左右[3-4]。肱骨骨折中大结节撕脱性骨折程度较为严重，临床上治疗该类骨折的有效方案是手术，手术的关键是恢复肱骨头与大小结节的关系，但患者预后仍较差[5]。基于这些临床依据，本次研究比较可吸收螺钉和肱骨近端解剖型钢板内固定治疗肱骨大结节撕脱性骨折的临床效果、安全性及患者预后，现将研究结果报告如下。

1 资料与方法

1.1 一般资料

2012年1月-2015年1月纳入肱骨大结节撕脱性骨折患者105例，患者年龄24～87岁，平均66岁，其中女69例，男36例。所有……