锁定钢板结合同种异体髂骨移植与腓骨移植治疗肱骨近端粉碎性骨折的对比研究

doi:10.3969/j.issn.10073205.2017.04.006

河北医科大学学报

锁定钢板结合同种异体髂骨移植与腓骨移植治疗肱骨近端粉碎性骨折的对比研究

河北医科大学第三医院创伤急救中心，河北省骨科研究所，河北省骨科生物力学重点实验室，河北石家庄 050051

出版日期:2017-04-25 发布日期:2017-04-25
作者简介:朱炼（1980-），男，河北栾城人，河北医科大学第三医院主治医师，医学博士，从事骨科疾病诊治研究。
基金资助:
河北省高等学校科学技术研究项目（QN2015261）

Emergency Center of Trauma, the Third Hospital of Hebei Medical University, Orthopaedic Research Institution of Hebei Province， Key Laboratory of Orthopaedic Biomechanics of Hebei Province， Shijiazhuang 050051， China

Online:2017-04-25 Published:2017-04-25

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察锁定钢板结合同种异体髂骨移植与腓骨移植治疗肱骨近端粉碎性骨折的临床效果。
〖HTH〗方法〖HTSS〗〖KG*2〗纳入肱骨近端粉碎性骨折患者39例，分为髂骨植骨组20例和腓骨植骨组患者19例,分别采用锁定钢板结合同种异体髂骨移植与同种异体腓骨移植治疗，并定期随访,比较2组骨折愈合时间、视觉模拟评分法（visual analogue scale,VAS）评分、SF36健康调查简表（the MOS item short from health survey,SF36）评分和术后肩关节活动范围。
〖HTH〗结果〖HTSS〗〖KG*2〗所有患者切口均甲级愈合，临床及放射学检查均取得骨性愈合。髂骨植骨组骨折愈合时间明显短于腓骨植骨组（P＜005）。术后屈曲、外旋及外展活动范围明显优于腓骨植骨组（P＜005）。髂骨植骨组末次随访疼痛程度显著低于腓骨植骨组（P＜005）。SF36评分显著高于腓骨植骨组（P＜005）。
〖HTH〗结论〖HTSS〗〖KG*2〗对于需行植骨治疗的肱骨近端粉碎性骨折患者，在制定手术方案时应尽量采用髂骨植骨。

关键词: 肩骨折, 骨移植, 髂骨

Abstract: ［Abstract］ Objective〖HTSS〗〓To observe the effect of allogenic iliac bone grafting and allogeneic fibula grafting combined with a locking plate in the treatment of comminuted proximal humeral fractures.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirtynine patients with proximal humeral fractures were included in this study. Twenty of them were treated with the locking compression plate fixation combined with iliac bone grafting and 19 were treated with the locking compression plate fixation combined with fibula grafting. The fracture healing time, visual analogue scale(VAS) score, the MOS item short from health survey(SF36) score and postoperative shoulder joint activities were followed up regularly.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓All the patients healed at the first grade and achieved bony union clinically and radiologically. The average fractures healing time of the patients in iliac bone grafting group was earlier than that in fibula grafting group（P＜0.05）. The range of flexion, external rotation and abduction in iliac bone grafting group was significantly better than that in fibula grafting group(P＜005）. The pain degree in the iliac bone grafting group was significantly lower than that in the fibula grafting group at the last followup（P＜005）. The SF36 score in iliac bone grafting group was significantly higher than that in fibula grafting group（P＜005）.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Compared with the fibula grafting group, the locking compression plate fixation combined with iliac bone graft revealed a better postoperative function on the treatment of comminuted proximal humeral fracture.

Key words: shoulder fractures, bone transplantation, ilium

朱〓炼，王〓博，赵昌平，彭阿钦，宋连新，张英泽*. 锁定钢板结合同种异体髂骨移植与腓骨移植治疗肱骨近端粉碎性骨折的对比研究[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2017.04.006.

ZHU Lian, WANG Bo, ZHAO Changping, PENG Aqin, SONG Lianxin, ZHANG Yingze*. [J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2017.04.006.

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锁定钢板结合同种异体髂骨移植与腓骨移植治疗肱骨近端粉碎性骨折的对比研究

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