中药外洗配合PHILOS钢板治疗肱骨近端粉碎性骨折的临床研究

目的:评估中药外洗配合PHILOS钢板内固定治疗肱骨近端粉碎性骨折的临床疗效。方法:回顾性分析2017年1月-2018年6月我院骨科42例因肱骨近端粉碎性骨折行PHILOS钢板手术治疗,术后2周配合中药外洗患者的临床资料。Neer分型:Ⅱ型18例、Ⅲ型24例;手术前及术后2周、1个月、6个月、12个月复查拍摄X线片,并采用Constant-Murley评分表评估肩关节功能恢复情况。结果:42例骨折均获得愈合,未出现内固定失败、断端不愈合等并发症,术后12个月肩关节Constant-Murley功能评分优良率:NeerⅡ型为88.9%(16/18),NeerⅢ型为83.3%(20/24),总优良率为85.7%(36/42)。术前与术后1个月Constant评分比较,具有显著差异(P<0.05),术后1个月与6个月、6个月与12个月Constant评分比较,不具有显著差异(P>0.05)。结论:中药外洗联合PHILOS钢板内固定治疗肱骨近端粉碎性骨折,可获得较满意的早期临床效果,值得推广。

Clinical research on washing traditional Chinese medicine and Philos plate with the treatmennt of comminuted fractures of proximal humeru

Objective:To investigate the clinical effect of washing Chinese medicine combined with Philos plate in the treatment of comminuted proximal humeral fractures.Methods:From January 2017 to June 2018,42 patients with comminuted fracture of proximal humerus underwent Philos plate operation in our hospital.2 weeks after operation,they were washed with traditional Chinese medicine.Among them,Neer’s Ⅱ was 18 patients and Neer’s Ⅲ 24 patients.X-ray were taken before and 2 weeks,3 months,6 months and 12 months after operation,and the function of shoulder was evaluated by Constant-Murley scoring table.Results:42 patients without wound infection or internal fixation failure.12 months after operation,The superior rate of was 88.9%(16/18)in Neer type Ⅱ,and83.3%(20/24)in Neer type Ⅲ,and the overallsuperior rate was 85.7%(36/42).There was statistical difference in Constant score before operation and 1 month after operation(P<0.05).There was no statistical difference in Constant score between 1 month and 6 months,6 months and 12 months after operation(P>0.05).Conclusion:Washing Chinese medicine with Philos plate internal fixation for the treatment of comminuted fractures of proximal humeru,should be promoted and extended.