回顾性分析手术内固定治疗老年肱骨近端骨折43例疗效  

Retrospective study of Surgical treatment for older patients with proximal humeral fractures

作　　者：刘洋[1] 刘金煜[1] 孙庆顺[1] 郗政[1] 

机构地区：[1]齐齐哈尔医学院第二附属医院骨外一科,黑龙江齐齐哈尔161006

出　　处：《中国伤残医学》2014年第9期12-14,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨手术内固定治疗老年肱骨近端骨折的疗效。方法：回顾性研究分析2009年7月～2012年8月采用手术切开复位内固定治疗43例老年（大于70岁）肱骨近端有移位骨折。9例因痴呆或死亡使随访数据不完整，剩余34例获得完整随访，平均随访时间2．1年（1～4．2年）。结果：骨折复位满意率87％。所有患者均获得骨性愈合。术后6％患者出现骨坏死。术后2周固定没有导致关节僵硬。至随访结束肩关节活动范围：平均屈伸143°±38°；平均外展131°±35°；内旋平均L1±2阶段，正常侧T8±2阶段；外旋35°±26°（表1）。平均ASES为69．5。结论：手术治疗老年肱骨近端骨折，术中仔细操作，对存在粉碎性骨折的给予充分植骨，术中内侧和内后侧复位良好，并采用短螺钉固定肱骨头，可以有效避免手术并发症并获得良好的关节功能。Objective：To discuss the effect of Surgical treatment for older patients with proximal humeral fractures .Mtehods：We retro-spectively reviewed all 43 patients older than 70 years with displaced proximal humerus fractures treated using open reduction and internal fixation technique between July 2009 and August2012.All patients were immobilized for 2weeks after surgery.Nine of the 43 patients ei-ther died or developed severe dementia during followup .The analysis included 34 patients followed an average of 2.1 years （range, 1-4. 2 years） .Results：An acceptable reduction was achieved in 87%of the shoulders and maintained over time .All fractures healed .Osteo-necrosis was noted on radiographs in 6%of the shoulders .Two weeks of immobilization did not lead to disabling stiffness .At most recent followup, mean active elevation was143°±38°, mean active external rotation 131°±35°, mean active internal rotation L1 ±2levels, mean active external rotation 35°±26°, and mean American Society of Shoulder and Elbow Surgeons score 69.5.Conclusions： With Carefully Operation , adequate bone graft , medial and posterointernal reduction , short screw , Surgical treatment for older patients with proximal humeral fractures could receive good shoulder function and avoid complications of surgery .

关 键 词：肱骨近端 骨折 老年 骨折内固定术 

分 类 号：R683.41[医药卫生—骨科学]