老年人肱骨近端二部分和三部分移位骨折19例临床分析

Clinical analysis of 19 elderly patients with displaced proximal humeral two- and three-part fractures

目的探讨老年人肱骨近端二部分和三部分移位骨折的手术治疗方法。方法回顾性分析19例老年肱骨近端二部分和三部分移位骨折患者的临床资料,其中二部分骨折13例、三部分骨折6例,采用切开复位,肱骨近端解剖钢板固定治疗。结果二部分骨折术后优良率为76.9%,未出现骨折不愈合及肱骨头坏死;三部分骨折术后优良率为66.7%,肱骨头坏死率16.7%。结论老年人肱骨近端二部分和三部分骨折应尽量采用有限切开复位,选择肱骨近端解剖钢板固定。

Objective To analyze the surgical approaches for treating displaced proximal humeral two-and three-part fractures in elderly patients. Methods Nineteen elderly patients with displaced proximal humeral fractures were analyzed, including 13 patients with displaced two-part fractures and 6 with displaced three-part fractures. All the patients were treated by open reduction and fixation with humeral anatomical bone plates. Results The rate of excellent or good healing was 76.9% for two-part fractures without nonunion or humeral head necrosis, and was 66.7% for three-part fractures with a rate of humeral head necrosis of 16.7%. Conclusion Displaced proximal humeral fractures in elderly patients should be managed with minimal open reduction and fixed with humeral anatomical bone plate.