小切口入路锁定加压钢板治疗老年肱骨近端骨折的疗效探讨

Effect of small incision of locking compression plate on proximal humeral fracture in elderly patients

目的 观察小切口入路锁定加压钢板治疗老年肱骨近端骨折的临床疗效.方法 选择老年肱骨近端骨折患者60例.按肱骨近端骨折Neer分型,其中两部分骨折22例,三部分骨折26例,四部分骨折12例.所有患者均采用肩关节前外侧小切口入路锁定加压钢板固定治疗,术后肩肘带悬吊固定,功能锻炼,进行VAS评分,随访观察12个月,进行X线片复查,肩关节功能Neer评分,同时观察不良反应的发生情况.结果 本手术患者术后VAS评分优良率为96.5％,所有患者均完成随访,术后12个月复查X线片示骨折均愈合,未出现肱骨头坏死征象,内固定位置可,未发现内固定松动和断裂.Neer评分优33例,良16例,可9例,差2例,优良率为81.7％.60例患者中6例偶发肩部疼痛,功能锻炼后自行缓解.结论 小切口入路锁定加压钢板治疗老年肱骨近端折患者效果佳,并发症少,可在临床推广.

Objective To observe the clinical effect of small incision of locking compression plate on proximal humeral fracture in elderly patients.Methods Sixty aged patients with proximal humeral fracture were chose.According to the fracture of the proximal humerus Neer type,two part fractures in 22 cases,three part fractures in 26 cases,four part fractures in 12 cases.All patients were treated with anterior shoulder lateral small incision locking compression plate fixation,postoperative shoulder elbow fixing belt suspension,functional exercise,followed in December,the X scan of the shoulder joint function,Neer score,and adverse reactions were observed.Results All patients completed the followup,12 months after the treatment,X ray results showed that all fractures healed,without humeral head necrosis signs,fixed position,without internal fixation loosening or fracture.The Neer scores were excellent in 33 cases,good in 16 cases,less good in 9 cases,poor in 2 cases,the excellent and good rate was 81.7%.Six cases had incidental shoulder pain,relieved after functional exercise.Conclusions The small incision locking compression plate in treatment of proximal humerus fracture in elderly patients has good effect,less complications,and can be popularized in clinics.