解剖钢板治疗老年肱骨外科颈粉碎性骨折

Humeral surgical neck comminuted fractures were treated with anatomical plate fixation in elderly patients

目的探讨应用解剖钢板内固定治疗老年患者肱骨外科颈粉碎性骨折的手术治疗效果。方法选择臂丛神经阻滞麻醉,取上臂上段前内侧切口经三角肌胸大肌间隙入路显露肱骨外科颈骨折,直视下将骨折复位,应用解剖钢板做内固定,伴有肱骨头骨折者用松质骨螺钉固定。结果本组24例,得到随访者21例,另2例外地患者失访,1例因为其他疾患术后3个月死亡。年龄62～86岁,平均72.5岁,随访9个月～3年,平均18个月,骨折均愈合,肩关节无疼痛,通过功能锻炼,肩关节功能基本恢复正常。结论老年患者肱骨外科颈粉碎性骨折通过切开复位解剖钢板内固定,可达到解剖复位,骨折愈合良好,功能恢复满意,明显改善患者生活质量。

Objective To investigate the treatment of humeral surgical neck comminuted fracture with anatomical plate fixation in elderly patients.Methods Under brachial plexus block anesthesia,humeral surgical neck fracture was revealed via arm medial incision through the gap between the deltoid muscle and pectoralis major.Then,reduction and anatomical plate fixation were performed under direct vision,and cancellous bone screws were applied if humeral head fracture existed.Results Among the 24 patients,21 were followed up,two were lost of follow-up,and one died of other disease after three months.The patients mean age was 72.5（62-86）years,and the average follow-up lasted for 18 months（9 months to 3 years）.All the fractures were healed up via exercises without pain and obvious functional limitation in the shoulders.Conclusion In elderly patients with comminuted fracture of surgical neck of humerus,good healing and functional recovery can be achieved by open reduction and fixation with anatomical plate,which help to improve their quality of life.