微创肱骨近端锁定接骨板结合可注射人工骨治疗高龄肱骨近端骨折的病例对照研究  

Case control studies on therapeutic effects of combined methods of minimally invasive percutaneous proximal humerus locked osteosynthesis plate with injectable bone for the treatment of proximal humerus fractures in elderly patients

作　　者：王照晖[1] 邓敦[1] 陈黎虬[1] 张维康[1] 颜海波[1] 陈笑宇[1] 梁忠[1] 蒋正辉[1] 

机构地区：[1]温州医学院附属温岭医院骨科,浙江温州317500

出　　处：《中国骨伤》2013年第5期404-407,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨微创肱骨近端锁定接骨板(PHILOS)结合可注射型人工骨治疗高龄肱骨近端骨折临床疗效。方法:2006年1月至2012年1月治疗肱骨近端骨折80例,分为研究组40例和对照组40例。研究组使用微创PHI-LOS结合可注射型人工骨治疗,男20例,女20例,平均年龄(68.4±11.9)岁;按AO分型,A1型2例,A2型3例,B1型6例,B2型7例,B3型9例,C1型6例,C2型7例。对照组使用微创PHILOS内固定,男18例,女22例,平均年龄(65.4±10.7)岁;按AO分型,A1型3例,A2型4例,B1型5例,B2型8例,B3型10例,C1型5例,C2型5例。观察两组患者骨密度、患者满意率、术后并发症发生情况、骨性愈合时间及肩关节功能评分情况。结果:研究组肱骨头坏死0例,肩内翻1例,内固定松动1例,满意36例,骨密度(1.013±0.109)g/cm2,骨性愈合时间(12.00±3.79)周,肩关节功能评分97.2±4.6。对照组肱骨头坏死3例,肩内翻5例,内固定松动6例,满意32例,骨密度(0.812±0.089)g/cm2,骨性愈合时间(20.00±8.67)周,肩关节功能评分78.5±3.2。参照Constant-Murley肩关节功能评分研究组优良36例,对照组优良32例。两组在骨密度、患者满意率、术后并发症发生情况、骨性愈合时间及肩关节功能评分方面比较差异均有统计学意义,研究组优于对照组(P<0.05)。结论:微创PHILOS结合可注射型人工骨治疗高龄肱骨近端骨折具有创伤小、固定牢固、能够早期功能锻炼的优点,可以达到良好疗效。Objective ： To evaluate the clinical effects of combined methods of minimally invasive percutaneous proximal humeral internal locking system （PHILOS） and injectable bone for the treatment of proximal humerus fractures in elderly pa- tients. Methods：From January 2006 to January 2012,80 patients with proximal humerus fractures were randomly divided into two groups（n=40）. The patients in the research group were treated with minimally invasive PHILOS fixation combined with in- jectable bone,including 20 males and 20 females,with an average age of （68.4±11.9） years; according to AO classification, 2 cases of type A1,3 cases of type A2,6 cases of type B1,7 cases of type B2,9 cases of type B3,6 cases of type C1,7 cases of type C2. The patients in the control group were treated with PHILOS fixation, including 18 males and 22 females, with an aver- age age of （65.4± 10.7 ） years ; according to AO classification, 3 cases of type A 1,4 cases of type A2,5 cases of type B 1,8 cas- es of type B2,10 cases of type B3,5 cases of type C1 ,and 5 cases of type C2. The BMD ,satisfactory rate,postoperative com- plications, bone healing time, Constant-Murley score in the two groups were reviewed and compared. Results ： In the research group,no patients had necrosis of femoral head, 1 patient had shoulder varus, 1 patient had internal fixation loosening,36 pa- tients were satisfactory with the treatment results, B MD was （1.013 ±0.109 ） g/cm2 , bone healing time averaged （12.00±3.79 ） weeks, and the Constant-Murley score was 97.2±4.6. In the control group,3 patients had necrosis of femoral head,5 patients had shoulder varus, 6 patients had internal fixation loosening, 32 patients were satisfactory with the treatment results, BMD was （0.812±0.089） g/cm2,bone healing time averaged （20.00±8.67） weeks,and the Constant-Murley score was 78.5±3.2. The re- suits of BMD,satisfactory rate,postoperative complications,bone healing time,and Constant-Murley score in the research group were better than th

关 键 词：肱骨骨折 骨折固定术 内 老年人 病例对照研究 

分 类 号：R681.7[医药卫生—骨科学]