| Objective:With the rapid and stable development of the market economy with Chinese characteristics,China is gradually transition to an aging society,the probability of injury to the greater tuberosity of the humerus has gradually increased,the application of steel plate to the greater tuberosity fracture surgery has been recognized by most orthopedic scholars and experts at home and abroad.However,with the further development of related studies,many scholars have found that the fracture of the greater tuberosity of the humerus accompanied by peripheral injuries is more common,and the greater tuberosity fracture is often accompanied by different degrees of destruction of adjacent bone and tissues.On the one hand,by consulting relevant literature and research data,this paper explores what kind of internal fixation plate can be used to firmly fix the greater tubercle fracture,and what kind of internal fixation plate has the least impact on the anatomical environment around the greater tubercle and has the best fracture healing effect.By comparison and analysis,on the other hand,orthopedic common methods(proximal humeral plate + an absorption line method)and I improved method(new anatomical steel plate + Orthocord line method of the greater tuberosity)during surgery and postoperative results of multiple aspects,such as,to explore the application of new type anatomical steel plate of the greater tuberosity + Orthocord line method of clinical curative effect of treatment.Methods:In this study,a retrospective study was conducted on patients admitted to the orthopaedic ward of our hospital with a definite diagnosis of greater tuberosity fracture between October 2016 and October 2020.A total of 103 patients were enrolled and divided into observation group(A)and control group(B).Observation group(A): 53 patients,including 23 males and 30 females,were treated with A new anatomical plate for greater tuberosity combined with orthocord line.Control group(B): 50 patients(22 males and28 females)were treated with proximal humerus plate plus non-absorbable line.There were 29 on the left and 24 on the contralateral in the observation group,and 27 on the left and 23 on the contralateral in the control group.Fracture classification for Neer Ⅱ type.All patients were followed up for 12 months.The fluoroscopy times,incision size,blood loss,duration of operation,length of stay in hospital,bone healing time,postoperative pain score and follow-up shoulder score of patients in group A and B were statistically analyzed.The rating scale of the American Shoulder and Elbow Surgeons(ASES)system was used to analyze and evaluate.Results:The analysis of the baseline data of patients in group A and B showed that P>0.05 was not statistically significant,so the surgical methods used in the observation group and the control group were comparable.The fluoroscopy times of patients in group A and B were 26.11±3.83 times and26.36±3.51 times.The size of incision was 5.70±0.69 cm,10.42±0.78 cm;The blood loss during operation was 57.85± 3.02 ml and 58.32± 2.90 ml.The duration of operation was 51.68 ± 4.67 minutes and 53.03 ± 4.90 minutes.The hospital stay days were 9.96±2.26 days and 9.78±1.98 days.The bony healing time of group A and B was 12.82±0.46 weeks and 12.75±0.46 weeks respectively.Postoperative pain scores were 6.06±1.49 and6.88±1.32.12 months after operation,the scores of shoulder joint were93.51±2.97 points and 86.41±3.65 points.T-test for the above data showed that the number of fluoroscopy,the amount of blood lost during surgery,the duration of the operation,the days in hospital and the duration of bone healing in the two groups(P>0.05)showed no statistical significance.Statistical analysis of incision size,postoperative pain score and shoulder joint evaluation in follow-up 12 months after operation in group A and B showed that P<0.05,the difference was statistically significant.So you can think of A,B two groups of patients in perspective,blood loss,perioperative cheng unavailable,days in hospital,and no obvious different osseous healing time and so on many aspects,and in the size of the incision,after surgery,the patient pain score,and 12 months after surgery,follow-up of shoulder joint score is different,several aspects,such as A group of patients in the size of the incision,after surgery,the patient pain score,and 12 months after surgery,follow-up of shoulder joint score more excellent than group B,The clinical effect of the new anatomical plate for greater tuberosity is more outstanding.Conclusion:The greater tuberous fracture of the humerus is one of the many types of proximal humerus fractures.Different methods of internal fixation will inevitably affect the clinical healing time and curative effect of the fracture and the repair of surrounding tissues.Compared with the proximal humeral plate,the new type of large nodule anatomical plate is more consistent with the concept of minimally invasive,more suitable for the surrounding anatomical environment of the large nodule,and has better biomechanical stability,and has less trauma to the fracture and surrounding tissues.The shoulder can be moved as early as possible after operation,which is conducive to the recovery and functional reconstruction of the large nodule fracture and surrounding soft tissue. |
PDF Full Text Request