评估锁定加压钢板在肱骨近端骨折内固定中的有效性:一项前瞻性研究

Shreel Koirala
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摘要

导言:锁定加压钢板(LCP)在治疗肱骨近端骨折(PHF)方面具有显著的生物学和生物力学优势,可提供更高的稳定性、血管保护、良好的愈合和更少的并发症。然而,如何将这些特性转化为对患者功能的益处仍有待阐明。本研究旨在从愈合率和功能结果的角度评估 LCP 在 PHF 内固定中的有效性。方法:这项前瞻性研究共招募了 30 名年龄大于 18 岁的肱骨近端骨折患者,男女患者均有。对他们进行为期 1 年的定期随访,并使用 Neer 标准和 Constant-Murray 评分对他们进行临床和放射学评估。结果采用卡方检验进行分析,P≤0.05 表示差异有统计学意义。结果平均年龄为(45.20±15.02)岁,男女比例为 2.3:1,大多数患者表现为右侧损伤 18 例(60%)和 Neer 4 部分损伤 13 例(43.33%),主要由道路交通事故所致 19 例(60%),Neer 评分满意 26 例(86.67%),Constant-Murray 评分良好 16 例(53.33%)。 受伤方式与年龄(P=0.013)有明显关系,但与性别(P=0.866)无明显关系。在随访期间,27 名(90%)患者的肱骨头高度保持不变,24 名(80%)患者的肱骨颈-轴角度良好。有12名(43.33%)患者的PHF在12周后出现放射学结合,27名(90%)患者没有出现脱位。然而,有1例(3.3%)患者没有出现骨结合。结论LCP 能使 PHF 患者快速愈合,并具有良好的刚性、角度稳定性和抗扭强度,因此在临床、功能和放射学方面都有良好的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of effectiveness of locking compression plates in internal fixation of proximal humerus fractures: a prospective study
Introduction: Locking compression plate (LCP) provides significant biological and biomechanical advantages in the management of proximal humerus fracture (PHF) by providing greater stability, vascular preservation, superior healing, and fewer complications. However, the translation of these properties to functional benefits for patients remains to be elucidated. The objective of the study was to evaluate the effectiveness of LCP in internal fixation of PHF in terms of rate of healing and functional outcomes. Method: This prospective study enrolled 30 Proximal Humerus Fracture patients aged >18 years, from both genders, and treated them with LCP. They were followed up regularly for 1 year and assessed clinically and radiologically using Neer’s criteria and Constant-Murray score. Results were analysed using Chi-square test, p≤0.05 indicated statistical significance. Result: With a mean age of 45.20±15.02 y and M:F ratio of 2.3:1, most patients showed right-sided injuries 18(60%) and Neer 4-part injuries 13(43.33%), predominantly due to road traffic accidents 19(60%), with a satisfactory Neer’s score 26(86.67%) and a good Constant-Murray score 16(53.33%).  The mode of injury showed significant association with age (p=0.013) but not with gender (p=0.866). Over follow up, 27(90%) patients maintained humeral head height and 24(80%) patients showed good humeral neck-shaft angle. Radiological union of PHF took 12 weeks in 12(43.33%) of patients with no dislocation in 27(90%) of patients. However, 1(3.3%) patient showed no union. Conclusion: LCP is associated with favorable clinical, functional and radiological outcomes in PHF patients by providing rapid healing and good rigidity, angular stability, and torsional strength.
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