2006-2016年达州骨科医院老年肱骨近端骨折患者非手术治疗疗效分析

Nonoperative Treatment of Proximal Humerus Fractures to Old People in Dazhou Orthopaedic Hospital From 2006 to 2016

目的探讨老年肱骨近端骨折患者非手术治疗的临床疗效。方法收集2006-01/2016-12在达州骨科医院收治的采用非手术治疗的108例老年肱骨近端骨折患者,其中男性52例,女性56例。年龄为60~81岁,平均年龄为(68.3±3.2)岁。跌倒伤83例,交通伤25例。Neer分型:Ⅰ型39例,Ⅱ型33例,Ⅲ型23例,Ⅳ型13例。原位超肩关节夹板固定31例,手法复位超肩关节夹板固定50例,手法复位外固定支架固定27例。均早期应用维生素D3、钙剂、降钙素等药物。结果随访时间为6~13个月,平均9.5个月,末次随访影像学显示骨折均愈合,肩关节功能评价采用Constant-murley评分标准,平均为88.5分,无1例并发症。结论非手术治疗方法对大多数老年肱骨近端骨折患者是安全有效的。

Objective To explore the clinical effects of nonoperative treatment of proximal humerus fractures to the old people. Methods About 108 cases were selected which was non-surgical treatment of proximal humerus fractures to old people in Dazhou Orthopaedic Hospital from Jan. 2006 to Dec. 2016. Among them,there were 52 male cases and 56 female cases. Aged from 60 to 81,the average age was 68. 3±3. 2 years old.About 83 cases were caused by fallen and 25 cases of traffic injuries. The Neer types： Neer Ⅰ had 39 cases,Neer Ⅱ had 33 cases and Neer Ⅲ had 23 cases,Neer Ⅳ had 13 cases. In situ,about 31 cases were fixed by using the super shoulder joint splint,and 50 cases were fixed by means of manipulation of the over-shoulder joint splint,and 27 cases were fixed by means of manipulation with external fixation. All of the cases were taken early application of vitamin D3,calcium,and calcitonin and so on. Results With over 6 months to 13 months follow-up visit,average of 9. 5 months,and the last follow-up imaging showed that all fractures were healed,and the shoulder joint function which was evaluated by Constant-murley standard was 88. 5 score.There were no complications. Conclusion Non-surgical treatment is a safe and effective method for most of the proximal humerus fractures in old age.