锁定钢板固定对老年肱骨近端骨折的疗效分析

doi:10.3969/j.issn.1009-976X.2020.03.024

摘要/Abstract

摘要： 目的研究在老年人中采用锁定钢板固定对肱骨近端骨折的临床效果。方法回顾性分析2016年9月~2019年6月遵义医科大学第五附属（珠海）医院收治的49例老年肱骨近端骨折患者的临床资料,其中32例接受肱骨近端锁定钢板固定手术,17例接受保守治疗。对比两组治疗效果、术后疼痛程度、肿胀程度、肩关节功能恢复情况。结果锁定钢板固定组的治疗有效率为（90.6%）,保守治疗组为（82.4%）,两组差异有统计学意义（P<0.05）;锁定钢板固定组患者术后1周的VAS评分低于保守组（P<0.05）,而术后肿胀程度恢复两组间差异无统计学意义（P>0.05）;锁定钢板固定组术后6月Neer评分、DASH评分、CMS反映的肩功能恢复均好于保守组（P<0.05）。锁定钢板固定组并发症较保守组高,但差异没有统计学意义（P>0.05）。结论锁定钢板固定术治疗老年肱骨近端骨折的临床效果良好,但不同患者应根据具体情况选择手术或保守治疗。

关键词: 锁定钢板固定, 老年, 肱骨近端骨折, 肩关节

Abstract: Objective To summarize the clinical effect of locking compression plate fixation in senile patients with proximal humerus fractures. Methods The clinical data of 49 elderly fracture patients admitted to the Fifth Affiliated Hospital （Zhuhai） of Zunyi Medical University from September 2016 to June 2019 were analyzed retrospectively. A total of 49 patients were included in this study, in whom 32 under went proximal humeral locking plate fixation and 17 will receive conservative treatment. The therapeutic effect, postoperative pain, postoperative swelling and functional recovery of shoulder joint were compared between the two groups. Results The effective rate of locking plate fixation group was （90.6%） and that of conservative treatment group was （82.4%）, the difference between the two groups was statistically significant （P<0.05）. VAS score of locking plate fixation group was lower than that of conservative group （P<0.05）, but there was no statistically significant difference between the two groups in the degree of postoperative swelling recovery （P>0.05）. Neer classification score, DASH score and CMS score of locking plate fixation group showed the recovery of shoulder function was better than that of the conservative group （P<0.05） at six-month follow-up. The complications in the locking plate fixation group were higher than those in the conservative group, but the difference was not statistically significant （P>0.05）. Conclusion Locking plate fixation has a good clinical effect in the treatment of proximal humeral fracture in the elderly, but different patients should choose operation or conservative treatment according to the specific situation.

Key words: elderly, locking plate fixation, proximal humerus fracture, shoulder joint

中图分类号:

R683.41

陈军平, 王国寿, 谭伟源. 锁定钢板固定对老年肱骨近端骨折的疗效分析[J]. 岭南现代临床外科, 2020, 20(03): 371-375.

CHEN Jun-ping, WANG Guo-shou, TAN Wei-yuan. Efficacy of locking compression plate systemfor treatment of senile patients with proximal humerus fractures[J]. Lingnan Modern Clinics in Surgery, 2020, 20(03): 371-375.

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