锁定钢板系统在老年肱骨近端骨质疏松性骨折中的疗效及远期预后分析  

Therapeutic Effect and Long-term Prognosis of Locking Plate System on Senile Osteoporotic Fractures of Proximal Humerus

作　　者：张沉冰[1] 乔静敏[2] 曹亚坤[3] 高金宝[1] 胡晓光[1] 张三兵[1] 

机构地区：[1]石家庄市第三医院手足外科,石家庄050000 [2]石家庄市第一医院内分泌二科,石家庄050000 [3]石家庄市第三医院功能科,石家庄050000

出　　处：《医学综述》2016年第20期4104-4106,共3页Medical Recapitulate

基　　金：河北省科技厅支持项目(152777128)

摘　　要：目的评价锁定钢板系统在老年骨质疏松性肱骨近端骨折中的效果及远期预后。方法选取2012年9月至2014年9月石家庄市第三医院收治的老年骨质疏松性肱骨近端骨折患者88例,采用随机数字表法将患者分为锁定钢板系统治疗组和普通钢板治疗组,其中锁定钢板系统治疗组44例,采用锁定钢板系统治疗;普通钢板治疗组44例,采用普通钢板治疗。观察并比较两组患者的手术时间、术中出血量、术后引流量及骨折愈合时间,比较两组患者术后并发症发生情况,评价两组患者肩关节功能恢复情况。结果锁定钢板系统治疗组手术时间长于普通钢板治疗组[(143.2±17.8)min比(110.0±21.0)min]、术中出血量及术后引流量少于普通钢板治疗组[(150.8±21.3)m L比(218.0±22.3)m L;(38.2±8.0)m L比(54.0±7.8)m L],差异有统计学意义(P<0.01),两组骨折愈合时间差异无统计学意义(P>0.05);锁定钢板系统治疗组患者的优良率为97.73%(43/44),普通钢板治疗组为86.36%(38/44),两组患者的疗效比较差异有统计学意义(Z=4.289,P=0.035);锁定钢板系统治疗组并发症发生率为2.27%(1/44),与普通钢板治疗组并发症发生率9.09%(4/44)比较,差异无统计学意义(P>0.05)。结论锁定钢板系统治疗老年骨质疏松性肱骨近端骨折的术中出血少,术后引流小,且并发症低,治疗效果良好,值得在临床上予以推广。Objective To evaluate the therapeutic effect and long-term prognosis of locking plate system on senile osteoperotic fractures of proximal humerus. Methods Total of 88 elderly patients with osteoporotic fractures proximal humerus in Shijiazhuang Third Hospital from Sep. 2012 to Sep. 2014 were included in the study and divided into a locking plate system group and a normal steal plate group according to the random number table method ,44 cases each group. The locking plate system group was treated with locking plate sys- tem,while the normal steel plate group was treated with common steel plate. Operation time, intraoperative blood loss, postoperative drainage volume and fracture healing time of the two groups were observed and compared. Postoperative complications of the two groups were compared. Shoulder joint function recovery status of the two groups was evaluated. Results The operation time [ （143.2 ± 17.8 ） rain vs （110. 0 ± 21.0） mini, intraoperative blood loss [ （ 150.8 ±21.3） mL vs （218.0±22. 3） mL] and drainage volume [ （38.2 ± 8. 0） mL vs （54. 0 ±7.8 ） mL ] of the two groups were statistically significant different （P 〈 0. 01 ）. The fineness rate of the locking plate system group was 97.73% （43/44） ,of the normal steel plate group was 86. 36% （38/44）, there was statistically significant difference between the the two groups （Z = 4. 289, P = 0. 035 ）. There was no significant difference in fracture healing time and complication rate [2. 27% （1/44） vs 9. 09% （4/44）] between the locking plate systems treatment group and normal steel plate group （ P 〉 0, 05 ）. Conclusion Locking plate system treatment of senile osteoperofic proximal humeral fractures is featured with less intraoperative bleeding, small postoperative drainage, less complications, and good treatment effect,thus is worthy of the clinical promotion.

关 键 词：肱骨近端骨折 骨质疏松 锁定钢板系统 预后 

分 类 号：R683.4[医药卫生—骨科学]