老年骨质疏松性肱骨近端骨折患者两种治疗方法的效果比较

Comparison of two approaches in treatment of the elder patients with osteoporotic fractures of the proximal humerus

目的探讨经皮闭合复位微创固定治疗骨质疏松性肱骨近端骨折的老年患者的临床疗效。方法回顾性分析在我院接受经皮闭合复位微创固定(A组,40例)或切开复位固定(B组,46例)治疗的老年肱骨近端骨折患者的临床资料,比较两组手术时间、术后住院时间、术后并发症发生率、Constant评分情况。结果两组患者手术时间(t=26.463,P=0)、住院时间(t=2.651,P=0.029)、术后并发症发生情况(χ2=8.227,P=0.004)比较,差异均有统计学意义,A组手术时间和住院时间均短于B组,术后并发症发生率也低于B组;Constant评分情况两组比较,差异无统计学意义(χ2=1.792,P=0.181)。结论经皮闭合复位微创固定疗法,在保证临床疗效的同时,提高了整个治疗过程中患者的安全性,对合并骨质疏松的老年肱骨近端骨折患者具有较高的临床应用价值。

Objective To explore the clinical effect of closed reduction and percutaneous pinning internal fixation in treatment of the elder patients with osteoporotic fractures of the proximal humerus.Methods The data of the patients on closed reduction and percutaneous pinning internal fixation（group A,40 patients） and open fixation（group B,46 patients） in our hospital were analyzed.The time of operation and hospitalization,incidence of complication after surgery and Constant score were compared between two groups.Results The time of operation（t=26.463,P=0） and hospitalization（t=2.651,P=0.029）,incidence of complication after surgery（χ2=8.227,P=0.004） in group A were significantly better than those in group B.The Constant score did not show significanct difference between two groups（χ2=1.792,P=0.181）.Conclusion The percutaneous pinning internal fixation approach ensures the clinical effect as well as safety in the process of treatment.It is appropriate to implement the method in treatment of the elder patients with osteoporotic fractures of the proximal humerus.