CAJ | 학술논문

目的比较顺行扩髓髓内钉(IMN)和动力加压钢板(DCP)治疗肱骨干骨折的疗效.方法选择47例肱骨干骨折患者,按随机数字表法分为两组:IMN组23例,DCP组24例,分别行IMN和DCP固定手术.术后比较两组围手术期、肩肘关节功能及并发症指标.结果所有患者随访时间为(22.3±5.7)个月,其中在12个月内失访3例,IMN组1例,DCP组2例.IMN组手术时间及术中出血量少于DCP组[(67.7±15.3) min比(87.0±12.5)min、(106.3±57.6) ml比(226.7±60.2) ml],差异有统计学意义(P＜0.05)；IMN组肩峰撞击症发生率高于DCP组[18.2％(4/22)比0],差异有统计学意义(P＜0.05)；IMN组切口感染发生率优于DCP组[4.5％(1/22)比22.7％(5/22)],差异有统计学意义(P＜0.05).其余指标两组间比较差异均无统计学意义(P＞0.05).结论 DCP在围手术期具有一定的优势,但在长期的随访中,DCP与IMN的肩肘关节功能和并发症并无明显差异.
목적 비교순행확수수내정(IMN)화동력가압강판(DCP)치료굉골간골절적료효.방법 선택47례굉골간골절환자,안수궤수자표법분위량조:IMN조23례,DCP조24례,분별행IMN화DCP고정수술.술후비교량조위수술기、견주관절공능급병발증지표.결과 소유환자수방시간위(22.3±5.7)개월,기중재12개월내실방3례,IMN조1례,DCP조2례.IMN조수술시간급술중출혈량소우DCP조[(67.7±15.3) min비(87.0±12.5)min、(106.3±57.6) ml비(226.7±60.2) ml],차이유통계학의의(P＜0.05)；IMN조견봉당격증발생솔고우DCP조[18.2％(4/22)비0],차이유통계학의의(P＜0.05)；IMN조절구감염발생솔우우DCP조[4.5％(1/22)비22.7％(5/22)],차이유통계학의의(P＜0.05).기여지표량조간비교차이균무통계학의의(P＞0.05).결론 DCP재위수술기구유일정적우세,단재장기적수방중,DCP여IMN적견주관절공능화병발증병무명현차이.
Objective To compare the clinical effects in patients treated with anterograde reamed intramedullary nail (IMN) and dynamic compression plate (DCP) for diaphyseal fractures of the humerus.Methods Forty-seven patients with diaphyseal fractures of the humerus,were divided into two groups by random digits table:IMN group (23 cases) and DCP group (24 cases),IMN and DCP were performed fixation,respectively.After the surgery,perioperative,functional outcomes of shoulder and elbow,postoperative complications between two groups were compared.Results The average follow-up time was (22.3 ± 5.7)months,3 cases were lost in 12-month-follow-up,1 case in IMN group and 2 cases in DCP group.The operation time,intraoperative blood loss in IMN group were significantly shorter than those in DCP group [(67.7 ± 15.3) min vs.(87.0 ± 12.5) min,(106.3 ±57.6) ml vs.(226.7 ±60.2) ml,P＜0.05].The incidence rate of subacromial impingement in IMN group was significantly higher than that in DCP group [18.2％ (4/22) vs.0,P ＜ 0.05].The incidence rate of wound infection in IMN group was significantly better than that in DCP group [4.5％(1/22) vs.22.7％(5/22),P ＜ 0.05].There were no statistically significant differences between two groups in other indexes (P ＞ 0.05).Conclusions DCP has some advantage in perioperative period,but they are comparable in the functional outcomes of shoulder and elbow and complications.