摘要
目的探讨解剖锁定钢板结合骨水泥髓内支撑技术治疗老年肱骨近端骨折的初步疗效。方法回顾性分析2016年5月至2018年7月解剖锁定钢板结合骨水泥髓内支撑技术治疗13例老年肱骨近端骨折患者资料。男5例,女8例;年龄60~84岁,平均71岁。所有患者骨折均为闭合性骨折,采用Neer分型:二部分骨折4例,三部分骨折5例,四部分4例。术后第6、12、18、36周及术后1年摄肩胛骨正、侧位X线片,末次随访时根据患者肩关节Constant评分及上肢功能障碍评定量表(DASH)评分评定功能。结果术后13例患者获3~12个月(平均6个月)随访。13例患者均获骨性愈合,其中2例术后1年出现肱骨头局部坏死变形,螺钉部分穿出,余患者无肱骨头内翻或螺钉穿出,无内固定物松动。末次随访时患者的Constant评分平均为82.6分(71~95分),DASH评分平均为19.2分(9.2~48.1分)。结论解剖锁定钢板结合骨水泥髓内支撑技术治疗老年肱骨近端骨折有助于骨折复位,增加固定强度,防止复位丢失,早期疗效较好。
Objective To evaluate anatomical locking plate combined with bone cement intramedullary support in the treatment of proximal humeral fractures in the elderly.Methods From May 2016 to July 2018,19 geriatric proximal humeral fractures were treated with anatomical locking plate combined with bone cement intramedullary support at Department of Orthopaedics,General Hospital of Shenyang Northern Theater.There were 8 females and 5 males,with an average age of 71 years(from 60 to 84 years).All the fractures were closed.According to the Neer classification,there were 4 two-part,5 three-part and 4 four-part fractures.At 6,12,18 and 36 weeks and one year postoperatively,anteroposterior and lateral X-ray films of the scapula were taken.At the last follow-up,the Constant-Murley shoulder score and the Disabilities of the Arm,Shoulder and Hand(DASH)score for the upper limb dysfunction were recorded.Results The 13 patients were followed up for 3 to 12 months(6 months on average).Bony union was achieved in all the 13 patients.Local necrosis and deformation of the humeral head and partial screw perforation were observed one year after operation in 2 cases,but other patients reported no such complications or loosening of internal fixation.At the last follow-up,their mean Constant-Murley score was 82.6(from 71 to 95)and their mean ADSH score 19.2(from 9.2 to 48.1).Conclusion Anatomical locking plate combined with bone cement intramedullary support may lead to fine early efficacy for the treatment of proximal humeral fractures in the elderly,since it can facilitate fracture reduction,promote rigid fixation and prevent loss of reduction.
作者
赵勇
乔跃跃
薛海鹏
杨超
周大鹏
Zhao Yong;Qiao Yueyue;Xue Haipeng;Yang Chao;Zhou Dapeng(Department of Orthopaedics,General Hospital of Shenyang Northern Theater,Shenyang 110016,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2021年第11期999-1002,共4页
Chinese Journal of Orthopaedic Trauma
基金
辽宁省科学技术计划项目。
关键词
老年人
肱骨骨折
近端
骨折固定术
内
骨水泥
Aged
Humeral fractures,proximal
Fracture fixation,internal
Bone cement
