内侧柱支撑重建联合常规内固定治疗对老年肱骨近端骨折患者愈合情况和肢体功能的影响  

Influence of medial column support reconstruction combined with routine internal fixation on healing and limb function of elderly patients with proximal humeral fractures

作　　者：张喜海[1] 卓乃强[1] 唐炼[1] 叶俊武[1] 鲁晓波[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000

出　　处：《中国现代医学杂志》2015年第16期62-65,共4页China Journal of Modern Medicine

摘　　要：目的分析内侧柱支撑重建联合常规内固定治疗对老年肱骨近端骨折患者愈合情况和肢体功能的影响。方法选择于2012年12月一2013年12月在该院接受手术治疗的78例老年肱骨近端骨折患者作为研究对象，按照随机数表法分为接受内侧柱支撑重建联合常规内固定治疗的观察组39例，接受单纯常规内固定治疗的对照组39例，随访时间13～18个月，平均15个月。比较两组患者的愈合情况、关节功能和关节活动度等差异。结果观察组患者接受治疗后的住院时间、影像学完全愈合时间及完全负重时间均短于对照组患者（P〈0．05）。观察组患者接受治疗后的CMS评分、Neer评分和Broberg—Morrey评分均高于对照组患者（P〈0．05）。观察组患者接受治疗后的肱骨颈干角、肱骨头内翻角度小于对照组。肩关节前屈上举、外拳和外旋角度均明显大于对照组患者（P〈0．05）。结论内侧柱支撑重建联合常规内固定治疗可以有效加速老年肱骨近端骨折患者的骨折端愈合，提升治疗后关节功能及活动度。[ Objective ] To analyze the influence of medial column support reconstruction combined with rontine internal fixation on proximal humeral fracture patients＂ healing and limb function. [ Methods ] Seventy-eight cases of elderly patients with proximal humeral fractures in our hospital between December 2012 and December 2013 were chosen as the research object. According to the stochastic indicator method, all patients were divided into observa- tion group （39 cases） received medial column support reconstruction combined with routine internal fixation and con- trol group （39 cases） received routine internal fixation, and were followed up for 13-18 months （mean 15 months）. Two groups of patients were compared in healing, joint function and joint mobility. [ Results ] The length of hospital stay, imaging complete healing time and full load time after treatment of observation group patients were shorter than those of control group patients （P 〈 0.05）. CMS rating, Neer scores, Broberg-Morrey scores of observation group pa- tients were higher than those of control group patients （P 〈 0.05）. Compared with patients in control group, humeral neck stem angle and humeral head varus angle of patients in observation group were smaller, while the flexion angle, abduction angle and external rotation angle of shoulder were greater （P 〈 0.05）. [ Conclusions ] Medial column sup- port reconstruction combined with routine internal fixation can effectively accelerate fracture healing of elderly pa- tients with fracture of humerus proximal end, and improve joint function and activity levels after treatment.

关 键 词：肱骨近端骨折 内侧柱支撑重建 肢体功能 

分 类 号：R683.41[医药卫生—骨科学]