不稳定肱骨近端骨折患者钢板内固定术后发生肱骨头内翻的影响因素  

Influencing factors of humeral head varus after plate internal fixation in patients with unstable proximal humerus fractures

作　　者：席银刚 XI Yingang(Department of Orthopedics of People’s Hospital of Yucheng County,Yucheng 476300 Henan,China)

机构地区：[1]虞城县人民医院骨科,河南虞城476300

出　　处：《中国民康医学》2022年第7期1-3,7,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨不稳定肱骨近端骨折患者钢板内固定术后发生肱骨头内翻的影响因素。方法:回顾性分析2019年1月至2020年1月该院收治的60例行钢板内固定术治疗的不稳定肱骨近端骨折患者的临床资料。随访1年,统计肱骨头内翻发生率,对不稳定肱骨近端骨折患者钢板内固定术后发生肱骨头内翻的相关因素进行单因素和多因素Logistic回归分析。结果:60例不稳定肱骨近端骨折患者钢板内固定术后发生肱骨头内翻11例,发生率为18.33%,未发生肱骨头内翻49例;发生肱骨头内翻患者受伤机制、骨质疏松、肱骨距螺钉置入、术中肱骨颈干角与未发生肱骨头内翻患者比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,肩关节外旋位损伤、骨质疏松、未置入肱骨距螺钉、术中肱骨颈干角<125°或>145°均为影响不稳定肱骨近端骨折患者钢板内固定术后发生肱骨头内翻的独立危险因素(OR>1,P<0.05)。结论:骨质疏松、未置入肱骨距螺钉、术中肱骨颈干角<125°或>145°均为影响不稳定肱骨近端骨折患者钢板内固定术后发生肱骨头内翻的独立危险因素。Objective:To explore influencing factors of humeral head varus after plate internal fixation in patients with unstable proximal humerus fractures.Methods:The clinical data of 60 patients with unstable proximal humerus fractures treated by plate internal fixation in our hospital from January 2019 to January 2020 were retrospectively analyzed and followed up for 1 year.The incidence of humeral head varus was analyzed.Univariate and multivariate Logistic regression analysis were performed to analyze the related factors of humeral head varus after plate internal fixation in the patients with unstable proximal humerus fractures.Results:In the 60 patients with unstable proximal humerus fractures,11 cases of humeral head varus occurred after the plate internal fixation with an incidence rate of 18.3%,and 49 cases did not have humeral head varus.There were significant differences in injury mechanism,osteoporosis,humeral calcar screw placement,and intraoperative humeral neck-shaft angle between the patients with humeral head varus and those without humeral head varus(P<0.05).Multivariate Logistic regression analysis showed that external rotation injury of the shoulder joint,osteoporosis,no humeral calcar screw placement,and intraoperative humeral neck shaft angle<125°or>145°were all the independent risk factors for humeral head varus in the patients with unstable proximal humerus fractures after plate internal fixation(OR>1,P<0.05).Conclusions:Osteoporosis,no humeral calcar screw placement,and the intraoperative humeral neck shaft angle<125°or>145°are all the risk factors for humeral head varus in the patients with unstable proximal humerus fractures after plate internal fixation.

关 键 词：不稳定肱骨近端骨折 钢板内固定术 肱骨头内翻 影响因素 

分 类 号：R683.41[医药卫生—骨科学]