两种术式在老年复杂性肱骨近端骨折患者中应用效果对比  

Comparison of the Efficacy of the Two Operations in Elderly Patients with Complex Proximal Humeral Fractures

作　　者：范海平 程浩 陈岩召 凌泽喜 童飞飞 FAN Haiping;CHENG Hao;CHEN Yanzhao;LING Zexi;TONG Feifei(Department of Orthopedic Trauma,Wuhan Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 432000,China;不详)

机构地区：[1]武汉中西医结合骨科医院(武汉体育学院附属医院)创伤骨科,湖北武汉432000

出　　处：《中国医学创新》2024年第10期105-108,共4页Medical Innovation of China

摘　　要：目的:探讨老年复杂性肱骨近端骨折患者应用锁定钢板内固定术与半肩关节置换术治疗的临床效果及对肩关节功能的影响。方法:回顾性选取2021年1月—2023年2月武汉中西医结合骨科医院收治的72例老年复杂肱骨近端骨折患者的临床资料,按手术方案不同分为两组。观察组(n=36)行半肩关节置换术治疗,内固定组(n=36)行锁定钢板内固定术治疗。比较两组的手术效果、临床相关指标、肩关节功能(Constant-Murley肩关节功能评分)及术后并发症。结果:两组手术优良率比较,差异无统计学意义(P>0.05)。观察组住院时间、手术时间均短于内固定组,术中出血量少于内固定组(P<0.05)。术后3个月,两组Constant-Murley肩关节功能评分中各项得分均高于术前(P<0.05),但两组组间比较差异均无统计学意义(P>0.05)。观察组并发症总发生率低于内固定组(P<0.05)。结论:针对老年复杂性肱骨近端骨折患者,锁定钢板内固定术与半肩关节置换术均能改善其肩关节功能,治疗效果相当,但后者的手术用时更短、术中出血量更少、患者恢复更快、安全性更高。Objective:To investigate the clinical efficacy of locking plate internal fixation and half-shoulder joint replacement in elderly patients with complex proximal humerus fractures and the effect on shoulder joint function.Method:The clinical data of 72 elderly patients with complex proximal humerus fracture admitted to Wuhan Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to February 2023 were retrospectively selected and divided into two groups according to different surgical protocols.The observation group(n=36)underwent half-shoulder joint replacement,and internal fixation group(n=36)underwent locking plate internal fixation.The operative effect,clinical correlation index,Constant-Murley score of shoulder joint function and postoperative complications were compared between the two groups.Result:There was no statistically significant difference in the excellent and good rate of operation between the two groups(P>0.05).The hospital stay and operation time of observation group were shorter than those of internal fixation group,and the intraoperative blood loss was less than that of internal fixation group(P<0.05).After 3 months of operation,the all the scores of Constant-Murley score of shoulder joint function in both groups were higher than those before operation(P<0.05),but there were no statistical significances between the two groups(P>0.05).The total complication rate of observation group was lower than that of internal fixation group(P<0.05).Conclusion:For elderly patients with complex proximal humerus fractures,locking plate internal fixation and half-shoulder joint replacement can improve shoulder function,and the treatment is comparable,but the latter has a shorter operation time,less intraoperative blood loss,faster patient recovery,and higher safety.

关 键 词：复杂性肱骨近端骨折 锁定钢板内固定术 半肩关节置换术 老年患者 

分 类 号：R687.3[医药卫生—骨科学]