锁定钢板内固定辅以内侧柱支撑重建治疗老年肱骨近端骨折的临床观察

Clinical Observation of Locking Plate Internal Fixation Combined with Reconstruction of Medial Column Support for the Treatment of Senile Proximal Humeral Fracture

目的探讨锁定钢板内固定辅以内侧柱支撑重建治疗老年肱骨近端骨折的临床效果。方法选择本院骨科符合标准患者86例,随机分为两组各43例。观察组予以锁定钢板内固定辅以内侧柱支撑重建治疗,对照组单纯行锁定钢板内固定治疗。结果两组患者均获得满意随访,平均随访时间(16.21±3.59)个月。末次随访时,观察组的肩关节Constant评分显著高于对照组(P<0.05),肱骨头内翻角、术后肱骨头高度比(r)、二次手术率、并发症发生率均显著低于对照组(P<0.05)。结论锁定钢板内固定辅以内侧柱支撑重建治疗老年肱骨近端骨折,可降低肱骨头内翻角度,减少肱骨头复位丢失,促进肩关节功能恢复。

Objective To explore the clinical effect of locking plate internal fixation combined with reconstruction of medial column support for the treatment of senile proximal humeral fracture. Methods A total of 86 cases of elderly patients with proximal humeral fracture were randomly divided into two groups equally. The control group was treated with locking plate internal fixation, while the observation group was treated with locking plate internal fixation combined with reconstruction of medial column support. Results Both groups had satisfactory follow-up, and the average follow-up time was （16.21 ± 3.59） months. At the final follow-up, the Constant score of shoulder joint of observation group was significantly higher than that of control group, and the varus angle of humeral head, second operation rate, humeral head height ratio （r） and incidence of complications were significantly lower than those of control group （all P〈0.05）. Conclusions Locking plate internal fixation combined with reconstruction of medial column support for the treatment of senile proximal humeral fracture can lower the varus angle of humeral head, reduce the loss of humeral head reset, and promote the recovery of shoulder function.