CAJ | 학술논문

背景：加拿大蒙特利尔学者Mutch等最近提出了一种新的肱骨大结节骨折形态学分型方法，将肱骨大结节骨折分为3种类型：撕脱型骨折、劈裂型骨折及压缩型骨折。 　　目的：比较传统钢板螺钉和空心螺钉置入内固定修复劈裂型肱骨大结节骨折后的肩关节功能恢复情况。 　　方法：对宜昌市夷陵医院骨科2010年1月至2014年1月收治的肱骨大结节患者按Mutch新分类方法分类，选择83例获得完整随访的劈裂型肱骨大结节骨折患者进行回顾性分析，其中23例采用钢板螺钉置入内固定治疗(钢板螺钉组)；60例采用空心螺钉置入内固定治疗(空心螺钉组)。采用目测类比评分、美国肩肘外科医师评分、Constant and Murley评分系统进行疗效评定，分析治疗前、治疗后患者的疼痛及肩关节功能变化。结果与结论：83例患者均获得随访，所有患者均1年取出内固定物。治疗前两组患者的目测类比评分、美国 　　肩肘外科医师评分、Constant and Murley评分比较差异均无显著性意义(P>0.05)，内固定取出后16个月随访时两组患者目测类比评分、美国肩肘外科医师评分、Constant and Murley 评分比较差异均有显著性意义(P<0.05)，空心螺钉组优于钢板螺钉组。提示空心螺钉置入内固定修复劈裂型肱骨大结节骨折操作简单，创伤较小，是一种比较理想的内固定方式，临床修复效果优于钢板螺钉置入内固定。
배경：가나대몽특리이학자Mutch등최근제출료일충신적굉골대결절골절형태학분형방법，장굉골대결절골절분위3충류형：시탈형골절、벽렬형골절급압축형골절。 　　목적：비교전통강판라정화공심라정치입내고정수복벽렬형굉골대결절골절후적견관절공능회복정황。 　　방법：대의창시이릉의원골과2010년1월지2014년1월수치적굉골대결절환자안Mutch신분류방법분류，선택83례획득완정수방적벽렬형굉골대결절골절환자진행회고성분석，기중23례채용강판라정치입내고정치료(강판라정조)；60례채용공심라정치입내고정치료(공심라정조)。채용목측류비평분、미국견주외과의사평분、Constant and Murley평분계통진행료효평정，분석치료전、치료후환자적동통급견관절공능변화。결과여결론：83례환자균획득수방，소유환자균1년취출내고정물。치료전량조환자적목측류비평분、미국 　　견주외과의사평분、Constant and Murley평분비교차이균무현저성의의(P>0.05)，내고정취출후16개월수방시량조환자목측류비평분、미국견주외과의사평분、Constant and Murley 평분비교차이균유현저성의의(P<0.05)，공심라정조우우강판라정조。제시공심라정치입내고정수복벽렬형굉골대결절골절조작간단，창상교소，시일충비교이상적내고정방식，림상수복효과우우강판라정치입내고정。
BACKGROUND:Canada Montreal Scholar Mutch et al have recently proposed a new morphologic classification of fracture of greater tuberosity of humerus. They divided these fractures into three typeavulsion, split and depression. OBJECTIVE:To compare the recovery of shoulder function after conventional plate-screw and hol ow-screw fixation for the repair of the split fracture of greater tuberosity of humerus. METHODPatients with greater tuberosity of humerus, who were treated in the Department of Orthopedics of Yichang Yiling Hospital, China from January 2010 to January 2014, were classified according to Mutch’s classification. A total of 83 patients with split greater tuberosity of humerus after complete fol ow-up were retrospectively analyzed. Of them, 23 cases received plate-screw fixation as plate-screw group, and 60 cases received hol ow-screw fixation as hol ow-screw group. Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems were utilized to assess the therapeutic outcomes. Patient’s pain and changes in shoulder function were analyzed before and after treatment. RESULTS AND CONCLUSION:A total of 83 patients were fol owed up. Fixator was obtained at 1 year after surgery in al patients. No significant difference in Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems was detected in both groups before treatment (P>0.05). Significant differences in Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems were detectable in both groups at 16 months after removal of the fixator (P<0.05). Data were better in the hol ow-screw group than in the plate-screw group. Above results suggested that hol ow-screw fixation in the repair of split fracture of greater tuberosite of humerus is simple to be operated, with smal trauma, and is an ideal fixation method. Clinical repair effect is better than plate-screw fixation.