内固定锁定系统治疗老年肱骨近端粉碎性骨折的疗效观察

Curative effects of fixation lock system treatment of senile proximal humeral comminuted fractures

目的评价肱骨近端锁定接骨板治疗老年肱骨外科颈粉碎性骨折的疗效。方法回顾性分析本院2008年6月～2011年6月收治入院的老年肱骨外科颈粉碎骨折40例患者的临床资料,其中20例采用肱骨近端锁定钢板,20例采用传统钢板交叉针治疗。观察两组患者手术情况、临床疗效、治疗评分等情况,并进行统计学比较。结果本研究中40例患者X线片显示均解剖复位,术后无骨折不愈合、延迟愈合和畸形愈合发生。全部患者均达到骨折一期愈合,愈合时间8～24周,平均(10.5±2.5)周。观察组临床疗效明显优于对照组,且差异有统计学意义,P<0.05。随访12个月观察组平均患肩得分明显高于对照组,且差异有统计学意义,P<0.05。结论肱骨近端锁定接骨板对老年肱骨外科颈粉碎骨折固定可靠,并发症少,可早期功能锻炼,具有防止复位丢失、保护板下血运和骨折愈合快等优点。手术中掌握良好复位技术,选择合适内固定,可获得满意的临床效果。

Objective To evaluate the efficacy of proximal humeral locking plate in treatment of elderly proximal humerus comminuted fracture. Methods The clinical data of 40 cases of elderly patients with proximal humerus comminuted frac- ture in our hospital from June 2008 to June 2011 were analyzed retrospectively. Of which 20 cases were treated with proximal humeral locking plate, other 20 cases were treated with traditional steel plate. The surgery situations, clinical efficacy, treatment score of the two groups were observed and compared. Results In this study, X-ray of 40 patients all showed anatomic reduction, and there was no postoperative fracture disunion, delayed healing and deformity healing. All patients reached fracture healing in first intention, the healing time was 8 to 24 weeks, the average time was （10.5＋2.5） weeks. The clinical efficacy of the observation group was better than the control group, the difference was statistical significance （P 〈 0.05） . After 12 months＇ follow-up, average score of risk shoulder of observation group was significantly higher than control group, the difference was statistical significance （P 〈 0.05）. Conclusion The proximal humerus locking plate in treatment of the elderly proximal humerus comminuted fracture patients can fix reliable, premots early functional exercise, prevents loss of reduction, protect the blood supply under the plate, and has few complications, and fracture healing time. Mastering good reset technique in the operation and select appropriate fixed method, we can get satisfactory clinical effect .