锁定型钢板治疗老年人肱骨近端骨折疗效分析  

Clinical effects of locking proximal humerus plate for humeral proximal fractures in elderly patients

作　　者：赵银必[1] 罗红芳[1] 尹华[1] 

机构地区：[1]江苏省金坛市人民医院骨科,213200

出　　处：《中华老年医学杂志》2013年第5期524-525,共2页Chinese Journal of Geriatrics

摘　　要：目的探讨锁定型钢板固定治疗老年人肱骨近端骨折的临床治疗效果。方法回顾性分析我院骨科老年肱骨近端骨折患者84例临床资料，随机分为观察组42例和对照组42例。观察组患者经切开复位采用锁定型钢板固定治疗，对照组患者切开复位采用克氏针治疗，随访1年，对两组患者治疗效果进行评价。结果观察组患者术中出血量为（189．2±27．5）ml，术后愈合时间为（102．3±6．2）d；对照组患者术中出血量为（177．6±28．2）ml，术后愈合时间为（99．9士6．8）d，差异无统计学意义（t=1．78、1．33，P-0．079、0．105）。患者出院后随访1年，观察组42例患者优22例（52．4％）、良18例（42．9％）、差2例（4．8％），优良率95．2％；对照组患者优15例（35．7％）、良22例（52．4％）、差5例（11．9％），优良率88．1％，观察组优良率高于对照组（X^2=3．18，P=0．028）。结论锁定型钢板固定治疗老年人肱骨近端骨折临床治疗效果较好，肩关节功能恢复良好。Objective To discuss the clinical effects of locking proximal humerus plate （LPHP） for humeral proximal fractures in elderly patients. Methods A total of 84 elderly patients with humeral proximal fractures were retrospectively analyzed. Patients were randomly divided into LPHP group and control group （n= 42, each group）. Patients in I.PHP group were treated with open reduction and internal fixation using LPHP. Patients in control group were treated with open reduction and Kirschner wire fixation. All patients were followed up for 1 year and the shoulder joint function was evaluated. Results There were no significant differences in bleeding volume and the wound healing time between LPHP group and control group [（189.2 ± 27.5） ml vs. （177.6± 28.2） ml, （102.3±6.2） days v.. （99.9±6.8） days, t=1.78, 1.33, P 0.079, 0.105, respectively]. One year after the follow up, there were 22 cases （52.4± 22/42） with excellent clinical evaluation, 18 cases （42.9% 18/42） with good clinical evaluation and 2 cases （4.8% 2/42） with poor clinical evaluation in LPHP group, and 15 cases （35.7% 15/42） with excellent clinical evaluation, 22 cases （52.4%, 22/42） with good clinical evaluation, and 5 cases （11.9% 5/42） with poor clinical evaluation in control group. There was a significant difference in the evaluation rate of excellent and good clinical efficacy between in LPHP group and in control group （95.2% vs. 88.1%, X^2 =3.18, P=0. 028）. Conclusions The internal fixation using LPHP has a good clinical effect in elderly patients with humeral proximal fractures, and it can well improve the recovery of shoulder joint function.

关 键 词：肱骨骨折 肩关节 骨折固定术 

分 类 号：R687.3[医药卫生—骨科学]