老年骨质疏松性肩关节周围骨折诊疗中国专家共识(2023版)  

Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly(version 2023)

作　　者：胡衍 王栋梁[1] 陈晓 施忠民[2] 周凤金 张建政 陈雁西 曹烈虎 王思成 王剑飞[8] 王宏亮[9] 冯勇 应志敏[11] 胡成栋[12] 韩庆林[13] 李明[14] 陈晓涛[15] 顾峥嵘 黄标通 熊蠡茗 张云飞 王志伟 禹宝庆 王勇 张磊[21] 杨雷[22] 童培建[23] 刘曦明 周强 牛丰[26] 杨伟国[27] 张文财[28] 陈世杰[29] 贾金鹏 杨强[31] 沈涛[32] 于斌[33] 张鹏 张勇 苗军[31] 孙廓[35] 林浩东 俞银贤[36] 王金武[37] 陶坤[38] 万大千 王蕾[40] 马昕[41] 易诚青 刘宏建[43] 张堃[3] 刘国辉[10] 张殿英[44] 侯志勇[45] 翁习生[33] 张英泽[45] 苏佳灿 中华医学会骨科学分会青年骨质疏松学组 中国老年学和老年医学学会老年病学分会骨科专家委员会 中国医师协会骨科医师分会青年委员会骨质疏松学组 上海中西医结合学会骨质疏松专业委员会 Hu Yan;Wang Dongliang;Chen Xiao;Shi Zhongmin;Zhou Fengjin;Zhang Jianzheng;Chen Yanxi;Cao Liehu;Wang Sicheng;Wang Jianfei;Wang Hongliang;Feng Yong;Ying Zhimin;Hu Chengdong;Han Qinglin;Li Ming;Chen Xiaotao;Gu Zhengrong;Huang Biaotong;Xiong Liming;Zhang Yunfei;Wang Zhiwei;Yu Baoqing;Wang Yong;Zhang Lei;Yang Lei;Tong Peijian;Liu Ximing;Zhou Qiang;Niu Feng;Yang Weiguo;Zhang Wencai;Chen Shijie;Jia Jinpeng;Yang Qiang;Shen Tao;Yu Bin;Zhang Peng;Zhang Yong;Miao Jun;Sun Kuo;Lin Haodong;Yu Yinxian;Wang Jinwu;Tao Kun;Wan Daqian;Wang Lei;Ma Xin;Yi Chengqing;Liu Hongjian;Zhang Kun;Liu Guohui;Zhang Dianying;Hou Zhiyong;Weng Xisheng;Zhang Yingze;Su Jiacan;Youth Osteoporosis Group of Chinese Orthopedic Association;Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics;Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons;Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine(Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China;Honghui Hospital,Xi′an Jiaotong University,Xi′an 710054,China;Seventh Medical Centre of PLA General Hospital,Beijing 100007 China;Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China;Luodian Hospital in Baoshan District,Shanghai 201908,China;Shanghai Zhongye Hospital,Shanghai 200941,China;Yan′an University Affiliated Hospital,Yan′an 716000,China;Fu Yang People′s Hospital,Fuyang 236000,China;Union Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430022,China;Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;Handan Central Hospital,Handan 056001,China;Affiliated Hospital of Nantong University,Nantong 226001,China;Ningbo No.6 Hospital,Ningbo 315040,China;Qinghai Provincial People′s Hospital,Xi′ning 810000,China;Institute of Translational Medicine,Shanghai University,Shanghai 20044

机构地区：[1]上海交通大学医学院附属新华医院,上海200092 [2]上海交通大学附属第六人民医院,上海200233 [3]西安交通大学附属红会医院,西安710054 [4]中国人民解放军总医院第七医学中心,北京100007 [5]复旦大学附属中山医院,上海200032 [6]上海市宝山区罗店医院,上海201908 [7]上海中冶医院,上海200941 [8]延安大学附属医院,延安716000 [9]阜阳市人民医院,阜阳236000 [10]华中科技大学同济医学院附属协和医院,武汉430022 [11]浙江大学医学院附属第二医院,杭州310009 [12]邯郸市中心医院,邯郸056001 [13]南通大学附属医院,南通226001 [14]宁波市第六医院,宁波315040 [15]青海省人民医院,西宁810000 [16]上海大学转化医学研究院,上海200444 [17]空军军医大学唐都医院,西安710038 [18]东方肝胆外科医院,上海200433 [19]上海市浦东新区人民医院,上海200135 [20]温州市中西医结合医院,温州325001 [21]上海中医药大学附属曙光医院,上海201203 [22]温州医科大学附属第二医院骨科,温州325027 [23]浙江省中医院,杭州310003 [24]解放军中部战区总医院,武汉430000 [25]重庆医科大学附属第三医院,重庆401120 [26]吉林大学白求恩第一医院,长春130062 [27]香港大学李嘉诚医学院,中国香港999077 [28]暨南大学附属第一医院,广州510630 [29]中南大学湘雅三医院,长沙410013 [30]中国人民解放军总医院第一医学中心,北京100048 [31]天津医院,天津300211 [32]中国医科大学附属盛京医院,沈阳110004 [33]北京协和医院,北京100032 [34]山东第一医科大学附属省立医院,济南250021 [35]南昌大学第二附属医院,南昌330006 [36]上海市第一人民医院,上海200080 [37]上海交通大学医学院附属第九人民医院,上海200011 [38]上海市第十人民医院,上海200072 [39]同济大学附属同济医院,上海200065 [40]上海交通大学医学院附属瑞金医院,上海200025 [41]复旦大学附属华山医院,上海200040 [42]复旦�

出　　处：《中华创伤杂志》2023年第4期289-298,共10页Chinese Journal of Trauma

基　　金：国家自然科学基金重大研究计划集成项目(92249303)。

摘　　要：肩关节周围骨折是老年人最常见的骨折类型之一,术后常出现内固定失败、肱骨头缺血坏死、上肢功能障碍等不良事件,严重危害老年人群运动健康。相比骨量正常的肩关节周围骨折类型,骨质疏松性骨折类型复杂、愈合慢、康复效果差,临床处理更为棘手,且目前国内尚无该类骨折诊疗的指南或共识。为此,中华医学会骨科学分会青年骨质疏松学组、中国老年学和老年医学学会老年病学分会骨科专家委员会、中国医师协会骨科医师分会青年委员会骨质疏松学组、上海中西医结合学会骨质疏松专业委员会组织相关专家制订《老年骨质疏松性肩关节周围骨折诊疗中国专家共识(2023版)》,从骨质疏松性肩关节周围骨折的诊断、治疗策略等方面提出9条推荐意见,旨在推广规范化、系统化、个性化诊疗理念,改善老龄化背景下骨质疏松性肩关节周围骨折患者功能预后与生活质量。Periarticular fracture of the shoulder is a common type of fractures in the elderly.Postoperative adverse events such as internal fixation failure,humeral head ischemic necrosis and upper limb dysfunction occur frequently,which seriously endangers the exercise and health of the elderly.Compared with the fracture with normal bone mass,the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation,so the clinical management becomes more difficult.At present,there is no targeted guideline or consensus for this type of fracture in China.In such context,experts from Youth Osteoporosis Group of Chinese Orthopedic Association,Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics,Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly(version 2023).Nine recommendations were put forward from the aspects of diagnosis,treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder,hoping to promote the standardized,systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

关 键 词：老年人 骨质疏松 肩骨折 康复 共识 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]