摘要
目的比较锁定加压钢板(LCP)与带锁髓内钉(LMN)内固定治疗老年肱骨近端骨质疏松性骨折的临床效果。方法回顾性分析2014年1月-2017年8月三峡大学附属仁和医院治疗83例肱骨近端骨折老年患者,采用LCP治疗52例,采用LMN治疗31例。LCP组男性19例,女性33例,年龄(73.8±8.2)岁;LMN组男性14例,女性17例,年龄(74.1±7.7)岁。比较两组患者术前一般资料、手术临床指标、术后肩关节Constant-Murley评分及术后并发症发生率等。结果两组骨性愈合时间[(14.1±1.8)周vs.(13.9±2.5)周]比较差异无统计学意义(P>0.05),两组患者术中出血量[(180.3±5.4)mL vs.(96.3±9.5)mL]、手术时间[(137.9±5.6)min vs.(108.6±8.6)min]和术后住院时间[(7.6±1.8)d vs.(4.2±1.8)d]比较差异有统计学意义(P<0.05);两组患者肩关节Constant-Murley评分在术后3个月[(57.2±3.8)分vs.(65.3±3.3)分]、6个月[(69.5±3.8)分vs.(74.4±4.4)分]、12个月[(81.1±3.5)分vs.(84.1±2.6)分]比较差异均有统计学意义(P<0.05);两组术后并发症发生率(5.76%vs.3.23%)比较差异无统计学意义(P>0.05)。结论相比LCP治疗肱骨近端骨质疏松性骨折,LMN治疗手术时间和术后住院时间更短,术中出血量更少,术后功能恢复更好。
Objective To compare the clinical effects of locking compression plate and interlocking intramedullary nail in the treatment of elderly patients with proximal humeral osteoporotic fractures.Methods From Jan.2014 to Aug.2017,83 elderly patients with proximal humeral osteoporotic fractures in Renhe Hospital Affiliated to Three Gorges University were selected as the study subjects.Fifty-two cases(LCP group)were treated with locking compression plate and 31 cases(LMN group)were treated with interlocking intramedullary nail.There were 19 males and 33 females in LCP group,aged(73.8±8.2)years;and 14 males and 17 females in LMN group,aged(74.0±7.7)years.The preoperative general data,surgical clinical index,postoperative shoulder joint Constant-Murley score and postoperative complication rate were compared between the two groups.Results There was no significant difference in bone healing time[(14.1±1.8)weeks vs.(13.9±2.5)weeks]between the two groups(P>0.05).The intraoperative blood loss[(180.3±5.4)mL vs.(96.3±9.5)mL],operation time[(137.9±5.6)min vs.(108.6±8.6)min],and postoperative hospital stay[(7.6±1.8)d vs.(4.2±1.8)d]were statistically significantly different(P<0.05).The postoperative shoulder joint Constant-Murley score in the two groups had statistical significance at postoperative 3 months[(57.2±3.8)points vs.(65.3±3.3)points],6 months[(69.5±3.8)points vs.(74.4±4.4)points]and 12 months[(81.1±3.5)points vs.(84.1±2.6)points]after operation(P<0.05).There was no significant difference in the incidence of postoperative complications(5.76%vs.3.23%)between the two groups(P>0.05).Conclusions Compared with locking compression plate in the treatment of proximal humeral osteoporotic fractures,the operation time and hospital stay of interlocking intramedullary nail are shorter,the amount of bleeding during operation is less,and the postoperative functional recovery is better.
作者
曾勇
韩庆斌
辛艺
徐留海
ZENG Yong;HAN Qing-bin;XIN Yi;XU Liu-hai(Department of Orthopaedics,Renhe Hospital Affiliated to Three Gorges University,Yichang,Hubei 443003,China)
出处
《创伤外科杂志》
2020年第1期46-49,共4页
Journal of Traumatic Surgery
关键词
肱骨近端骨折
骨质疏松
钢板
髓内钉
内固定
老年
proximal humerus fracture
osteoporosis
plate
intramedullary nail
internal fixation
elderly
