骨水泥棒髓内植入联合PHILOS钢板治疗老年骨质疏松型肱骨近端骨折  

Treatment of osteoporotic proximal humeral fractures in the elderly with bone cement rod intramedullary implantation and PHILOS plate

作　　者：马志强 买买艾力·玉山 王筠[1] MA Zhi-qiang;MAImaiaili·yushan;WANG Yun(Department of Trauma Surgery,Afiliated TCM Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830000,China)

机构地区：[1]新疆医科大学附属中医医院创伤骨科,乌鲁木齐830000

出　　处：《中国骨与关节杂志》2023年第8期593-599,共7页Chinese Journal of Bone and Joint

摘　　要：目的探讨骨水泥棒髓内植入联合PHILOS钢板治疗老年骨质疏松型肱骨近端骨折的疗效。方法回顾分析2018年1月至2021年12月,我院创伤骨科收治的采用该技术治疗的老年骨质疏松型肱骨近端骨折患者的资料,共48例,其中男8例,女40例,平均年龄(78.19±9.10)岁;骨折NEER分型:二部分骨折10例,三部分骨折32例,四部分骨折6例。采用Constant评分和DASH评分进行评价。结果所有纳入患者均成功获得随访,平均随访(29.50±10.58)个月。所有病例均获得临床骨折愈合。患者DASH评分平均(20.50±10.76)分(范围0~40),Constant评分平均(75.79±9.93)分(范围54~94);48例中3例发生并发症:1例术后1个月再次跌倒受伤致大结节骨块移位,患者拒绝再次手术,后期出现大结节骨吸收。肱骨头缺血性坏死2例,2例均为高龄患者四部分骨折脱位,患者对肩关节功能满意,未行进一步手术治疗。结论骨水泥棒髓内植入联合PHILOS钢板治疗老年骨质疏松型肱骨近端骨折具有满意的疗效。Objective To investigate the effect of bone cement rod intramedullary implantation combined with PHILOS plate in the treatment of elderly osteoporotic proximal humeral fractures.Methods From January 2018to December 2021,48 elderly patients with osteoporotic proximal humeral fractures were treated in the Department of Trauma Surgery of the Affiliated TCM Hospital of Xinjiang Medical University,including 8 males and 40 females with an average age of(78.19±9.10)years;NEER fracture classification:10 were two-part fracture,32 were three-part fracture,and 6 were four-part fracture.Constant score and DASH score were used for evaluation.Results All included patients were successfully followed up for an average of(29.50±10.58)months.Clinical healing was achieved in all cases.The average DASH score of patients was(20.50±10.76)(range:0-40),and the average Constant score was(75.79±9.93)(range:54-94).Complications occurred in 3 of the 48 patients.One patient fell again one month later,and displacement of the greater tubercle occurred.The patient refused re-operation,and eventually leading to greater tuberous bone resorption.Two cases of humerus head ischemic necrosis were observed.Both of them were elderly patients with four-part fracture dislocation.No further surgical treatment was applied because the patients were satisfied with shoulder function.Conclusions Bone cement rod intramedullary implantation combined with PHILOS plate has a satisfactory effect in the treatment of elderly osteoporotic proximal humeral fracture.

关 键 词：肱骨骨折 肩骨折 骨折固定术 内 骨质疏松 

分 类 号：R685.4[医药卫生—骨科学]