内固定结合抗骨质疏松药物治疗老年肱骨近端骨折  

Treatment of Proximal Humeral Fractures with Internal Fixation and Antiosteoporotic Drugs in Elderly Patients

作　　者：衡立松[1] 朱养均[1] 张堃[1] 张军[1] 段虹昊[1] 

机构地区：[1]西安交通大学医学院附属红会医院创伤骨科上肢病区,陕西西安710054

出　　处：《实用骨科杂志》2016年第8期686-689,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨抗骨质疏松药物(鲑鱼降钙素、阿法骨化醇、维生素D咀嚼钙片)在老年肱骨近端骨折内固定术后治疗中的效果。方法将98例老年肱骨近端骨折按患者意愿分为治疗组和对照组。治疗组50例,内固定术后第2天应用抗骨质疏松药物治疗;对照组48例,内固定术后未用抗骨质疏松药物治疗。结果所有患者均获得12个月以上随访。治疗组骨折愈合时间平均(12.8±0.8)周,比对照组平均(15.3±0.5)周短;肩关节功能Neer评分优良率(92.0%)高于对照组(77.1%),差异均有统计学意义(P<0.05);治疗组并发症发生率(10.0%)低于对照组(27.1%)。治疗组抗骨质疏松治疗后健侧肱骨近端密度明显增高,差异有统计学意义(P<0.05)。结论内固定结合抗骨质疏松药物治疗对老年肱骨近端骨折有促进骨折愈合、降低手术并发症发生率和增加骨密度的作用,临床疗效满意。Objective To evaluate the clinical efficacy of antiosteoporotic drugs（ Salmon calcitonin,Alfacalcidol and Calcium tablet） for senile osteoporotic proximal humeral fractures after internal fixation. Methods 98 cases were divided into the treatment group（ 50 cases） and the control group（ 48 cases） according voluntary,The treatment group accepted antiosteoporotic drugs after operation,while the control group not. Results All patients were followed up for more than 12 months. The fracture healing time of treatment group was（ 12. 8 ± 0. 8） weeks,which was shorter than that of control group（ 15. 3 ± 0. 5）. The excellent and good rate of Neer shoulder score of treatment group was 92. 0%,which was higher than that of control group＇s 77. 1%.The incidence of surgical complications of treatment group was 10. 0%,which was less than that of control group＇ s 27. 1%.There was significant difference（ P〈0. 05）. In treatment group,antiosteoporotic drugs were used post-operatily. In proximal humeral of healthy side,the BMD（ bone mineral density） was significantly increased,there ＇ s significant difference（ P〈0. 05）. Conclusion internal fixation combined with antiosteoporotic drugs can promote the fracture healing,reduce te incidence of complications,increase BMD and has satisfactory clinical effect for senile osteoporotic proximal humeral fracture.

关 键 词：肱骨近端骨折 内固定 骨质疏松 骨密度 药物 

分 类 号：R683.41[医药卫生—骨科学]