| 改良透视方法在肱骨近端骨折内固定术中的应用 |
| |
| 引用本文： | 杨寅,曹军军,刘邦定,梁晨,唐永亮,王莹莹,张延平,郭华. 改良透视方法在肱骨近端骨折内固定术中的应用[J]. 中华解剖与临床杂志, 2021, 26(2): 132-137. DOI: 10.3760/cma.j.cn101202-20200308-00069 |
| |
| 作者姓名： | 杨寅 曹军军 刘邦定 梁晨 唐永亮 王莹莹 张延平 郭华 |
| |
| 作者单位： | 陕西省西安市中心医院骨二科 710003;陕西中医药大学护理学院，咸阳 712000 |
| |
| 基金项目： | 陕西省重点研发计划(2020SF-197) |
| |
| 摘 要： | 目的:探讨改良透视方法在肱骨近端骨折内固定术中应用可行性。方法:前瞻性研究。纳入2017年6月—2019年12月西安市中心医院骨二科单纯肱骨近端骨折患者36例，其中男12例、女24例，年龄61～79岁。骨折按Neer分型，3部分骨折25例，4部分骨折11例。按随机数字表法分为对照组和观察组，每组18例。两组患者均采用胸...
|
| 关 键 词： | 肱骨骨折 骨折固定术，内 X线透视检查 |
| 收稿时间： | 2020-03-08 |
Application of a modified intraoperative fluoroscopy method in open reduction and internal fixation of proximal humeral fractures |
| |
| Yang Yin,Cao Junjun,Liu Bangding,Liang Chen,Tang Yongliang,Wang Yingying,Zhang Yanping,Guo Hua. Application of a modified intraoperative fluoroscopy method in open reduction and internal fixation of proximal humeral fractures[J]. Chinese Journal of Anatomy and Clinics, 2021, 26(2): 132-137. DOI: 10.3760/cma.j.cn101202-20200308-00069 |
| |
| Authors: | Yang Yin Cao Junjun Liu Bangding Liang Chen Tang Yongliang Wang Yingying Zhang Yanping Guo Hua |
| |
| Affiliation: | 1.The Second Department of Orthopedics, Xi'an Central Hospital, Xi'an 710003, China;2.Nursing College of Shaanxi University of Chinese Medicine, Xianyang 712000, China |
| |
| Abstract: | Objective This study aimed to investigate the feasibility of the application of a modified intraoperative fluoroscopy method in open reduction and internal fixation of proximal humeral fractures. Methods A prospective study was conducted. Thirty-six patients suffering from a simple proximal humeral fracture, including 12 males and 24 females (aged 61-79 years), were enrolled in the Second Department of Orthopedics, Xi'an Central Hospital from June 2017 to December 2019. On the basis of the Neer classification of proximal humeral fractures, 25 cases were three-part fractures and 11 cases were four-part fractures. They were divided into the observation group and control group by a random number table, with 18 cases in each group. Two groups of patients were treated with open reduction and internal fixation with plates through the ectopectoralis-deltoid approach. The control group was intraoperatively treated with traditional X-ray fluoroscopy, whereas the observation group was treated with modified X-ray fluoroscopy. The clinical baseline data in patients, the number and time required for the last round of intraoperative AP and lateral views of X-ray fluoroscopy, the operative time, the intraoperative blood loss, and the postoperative complications were compared between the two groups. Twelve months after surgery, the time of fracture union and the outcomes according to the Neer score criterion of shoulder joint were also compared between the two groups. Results No significant differences were found in gender, age, Neer classification, and other clinical baseline data between the two groups (all P values＞0.05). In the control group, the number of fluoroscopy required for the last round was three to seven times (4.2±1.2) and the cumulative time was 3.5-15.0 min (5.6±2.6). In the observation group, the number of X-ray fluoroscopy required for the last round was two to five times (2.5±0.9), and the cumulative time was 2.5-6.5 (3.1±1.0) min; the differences were statistically significant (t= 4.808, 3.808, all P values＜0.01). The operative time and intraoperative blood loss of the observation group were 77 ±5 min and (84±5) mL, respectively. All values were lower than (85±6) min and ( 94±8) mL in the control group, and the differences were statistically significant (t=4.335, 4.384, all P values＜0.01). Patients in both groups were followed up for 3-12 months after surgery. During the follow-up period, no postoperative complications such as loss of reduction, failure of internal fixation, nonunion of fracture, and deep infection occurred in patients of both groups. The 14 patients in the observation group and 13 patients in the control group were followed up for 12 months, and no significant difference were found in the time of fracture union and Neer scores (all P values＞0.05). On the basis of the Neer score criterion of shoulder joint, 7 cases were excellent, 6 cases were good, and 1 case was fair in the observation group, whereas 6 cases were excellent, 6 cases were good, and 1 case was fair in the control group. Conclusions The modified intraoperative X-ray fluoroscopy method can reduce the radiation exposure of the surgeon and the patient compared with traditional fluoroscopy. This method is worthy of being recommended in clinical settings because it is reproducible and easy to implement and indirectly shortens the operative time to decrease bleeding during operation and the risk of postoperative incision infection. |
| |
| Keywords: | Humeral fracture Fracture fixation internal Fluoroscopy |
| 本文献已被 万方数据 等数据库收录！ |
| 点击此处可从《中华解剖与临床杂志》浏览原始摘要信息 |
|
点击此处可从《中华解剖与临床杂志》下载全文 |
|
