可塑纸板有限外固定治疗老年性肱骨近端粉碎性骨折  

Limited external fixation of plastic cardboard for the treatment of senile comminuted humeral fracture

作　　者：陶帅[1] 陈凤华 王铠[1] 龚华惠[1] 沈绍勇[1] 吉万波[2] 刘锦涛[2] 姜宏[2] TAO Shuai;CHEN Feng-hua;WANG Kai;GONG Hua-hui;SHEN Shao-yong;JI Wan-bo;LIU Jin-tao;JIANG Hong(Department of Orthopaedics,Suzhou Hospital of TCM Affiliated Nanjing University of Chinese Medicine,Suzhou 215009,Jiangsu,China)

机构地区：[1]南京中医药大学泰州附属医院,江苏泰州225300 [2]南京中医药大学苏州附属医院,江苏苏州215009

出　　处：《中国骨伤》2019年第1期22-27,共6页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨可塑纸板有限外固定治疗老年性肱骨近端粉碎性骨折的临床疗效。方法 :自2015年6月至2017年12月收治32例老年性肱骨近端粉碎性骨折患者,经手法整复后行可塑纸板有限外固定,其中男13例,女19例;年龄55～85(68.22±8.36)岁;左侧18例,右侧14例。所有患者定期复查肩关节X线片并指导其进行适当功能锻炼,于术后3个月采用Constant-Murley肩关节评分进行临床疗效评价。结果:32例患者获得随访,时间3～12 (4.97±2.39)个月。所有患者在医师指导下行功能锻炼,9例患者结合局部中药湿热敷进行局部理疗促进肩关节功能恢复。术后31例达到骨性愈合,愈合时间5～12(7.44±1.72)周,1例未愈合因骨折断端粉碎明显且分离移位大,肱骨头血供不足出现肱骨头坏死吸收。术后3个月Constant-Murley肩关节评分为87.56±6.93;其中优15,良14,可2例,差1例。结论:采用可塑纸板有限外固定保守治疗老年性肱骨近端粉碎性骨折,保证了骨折断端的生物力学稳定,有利于患者进行早期功能锻炼,促进肩关节功能的早期恢复,缩短了康复时间,创伤小,患者易于接受。Objective:To explore clinical efficacy of limited external fixation with plastic paperboard in treating senile proximal comminuted humeral fracture.Methods:From June 2015 to December 2017,32 senile patients with proximal comminuted fracture of humerus were treated with plasticized cardboard after manual external fixation.Among them,including 13 males and 19 females aged from 55 to 85 years old with an average of(68.22±8.36)years old;18 patients on the left side and 14 patients on the right side;all patients were regularly review shoulder X-rays and performed appropriate functional exercises.Constant-Murley shoulder joint scoring was used to evaluate clinical effects.Results:Thirty-two patients were followed up for 3 to 12 months with an average of(4.97±2.39)months.All patients were underwent functional exercise under guidance of physicians.Nine patients were treated with topical Chinese herbal moist heat compresses to promote shoulder function recovery.Thirty-one patients were obtained fracture healing,the time ranged from 5 to 12 weeks with an average of(7.44±1.72)weeks.One patient was not healed due to comminuted fracture of fracture end and the separation was large,the blood supply to humeral head was insufficient for necrosis absorption.Postoperative Constant-Murley shoulder score at 3 months was 87.56±6.93;15 patients got excellent results,14 good,2 fair and 1 poor.Conclusion:Limited external fixation with plastic paperboard for the treatment of senile proximal comminuted humeral fracture could ensure biomechanical stability of fracture,promote early recovery of shoulder joint function and shorten recovery time.

关 键 词：骨折固定术 肱骨 骨折 粉碎性 老年人 

分 类 号：R683.41[医药卫生—骨科学]