| Purpose:By means of locking compression plate and interlocking intramedullarynail internal fixation in the treatment of humeral fractures in middle curative effectanalysis,To explore the two methods in the middle part in the treatment of humeralfractures in application,In order to better use two kinds of methods, to better achievesatisfactory therapeutic effect.Methods:Aretrospective analysis method,Select the second affiliated hospital ofdalian medical university in March2011to March2014diagnosed with middle to shaftof humerus fractures and hospitalization in patients undergoing surgery for65cases.According to the operation method is different, it is divided into two groups, lockingcompression plate and interlocking intramedullary nail group. Followed up for6~24months, an average of13.6months.5patients with loss prevention during the follow-upperiod,60patients with follow-up (locking compression plate group30cases,interlocking intramedullary nailing group30cases).Locking compression plate group30cases, of which the male16cases,14cases women, ages24to70years old, theaverage age of40.On the left side of the19cases,11cases on the right side.Accordingto theAO type: type A17cases,10cases of type B, type C (3cases). Injury reason:falling16cases, traffic accident7cases, high fall injury in4cases, heavy parts in2cases,1case of arm-wrestling damage.Interlocking intramedullary nailing group30cases,18cases of men, women,12cases, aged22to78, the average age of42. On theleft side of the17cases,13cases on the right side.According toAO classification:15 cases were typeA, type B12cases of type C3cases. Cause: fall12cases,8cases oftraffic accidents, high falling injury in7cases, heavy parts in3patients. Lockingcompression plate group and interlocking intramedullary nails in the gender, age, theleft and right sides, AO type, cause, etc (P>0.05) there were no significant differencesbetween comparable. Compare two groups of operation time, intraoperative blood loss,postoperative shoulder joint function, healing time and complications (nerve injury,postoperative infection, acromion injury, bone nonunion bone healing, so screwbreakage).Results: Locking compression plate group operation time was116.7±38.1min,Hand in interlocking intramedullary nailing group operation time was107.8±32.0min,Showed no significant difference between two (p>0.05); Bleeding amount oflocking compression plate group was206.7±101.6ml, pay the bleeding amount oflocked intramedullary nailing group was247.8±114.1ml, statistical analysis showedthat no difference (p>0.05). Neer system evaluation is used to assess function ofshoulder joint.Locking compression plate group:18cases,11cases,1case,0cases, finerate was96.67%; Hand in interlocking intramedullary nail group:11cases,10cases,5cases,4cases, fine rate was70.00%, Although the two groups was60%or more, butgood shoulder joint function after surgery for locking compression plate is high in theintramedullary nailing group.Fracture healing time, locking compression plate group10.5±1.4W, intramedullary nailing group14.2±1.6W, statistical processing anddisplay of locking compression plate group is different between the intramedullarynailing group (P <0.05).Locking compression plate group,2cases occurred after radialnerve palsy,1case with infection, does not appear the shoulder injury, bone nonunionbone healing and so, the incidence of complications was10.00%; Hand in lockedintramedullary nailing group had the acromion injury in5cases, bone nonunion bonehealing in1case, does not appear radial by injury, infection, and screw breakage, theincidence of complications was20.00%.Conclusion: The results indicate that,In operation time, intraoperative blood loss,locking compression plate group with interlocking intramedullary nails were not significantly different, But the locking compression plate group of shoulder jointfunction after surgery, fracture healing time, the incidence of complications than lockingintramedullary nailing group is good.Locking compression plate more accord withmodern orthopaedic advocated by "fully protects the end blood supply, a dynamic blockand the main fracture quick connection" biological point of view, is the main method forthe treatment of middle to shaft of humerus fracture. |
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