老年肩关节脱位手法复位致肱骨近端骨折的手术疗效分析

Operative treatment of humeral anatomical neck fracture caused by failed reduction of shoulder dislocation in elderly patients

目的分析人工关节置换与内固定术对老年肩关节脱位手法复位失败致肱骨解剖颈骨折患者的疗效。方法选取2009年6月-2016年7月于吉林医药学院附属医院收治的25例老年肩关节脱位手法复位失败致肱骨解剖颈骨折患者。比较两组患者的手术时间、出血量、术后并发症、肩关节Constant-Murley评分及Neer评分。结果关节置换组的手术时间、出血量、术后并发症均少于内固定组(P<0.05);两组肩关节Constant-Murley评分、Neer评分及优良率比较无差异(P>0.05)。结论人工肩关节置换治疗老年肩关节脱位手法复位失败致肱骨解剖颈骨折患者手术用时少、出血量少且术后并发症少,值得广泛推广。

Objective To compare the effect of artificial joint replacement and internal fixation on the treatment of humeral anatomical neck fracture caused by failed reduction of shoulder dislocation in elderly patients.Methods Twenty-five elderly patients with humeral anatomical neck fracture caused by failed manual reduction of shoulder dislocation in our hospital from June 2009 to July 2016 were retrospectively analyzed,among which 14 patients underwent artificial shoulder arthroplasty(joint replacement group)and 11 patients underwent open reduction and internal fixation(open reduction and internal fixation group).The operative time,bleeding volume,postoperative complications,shoulder joint Constant-Murley score and Neer score were compared between the two groups.Results The operative time was shorter,the blood volume was smaller and the postoperative complications were significantly fewer in the joint replacement group than in the open reduction and internal fixation group(P<0.05).There was no significant difference in the Constant-Murley score,Neer score or the excellent and good rate of the shoulder joint between the two groups(P>0.05).Conclusions In the treatment of humeral anatomical neck fracture caused by failed reduction of shoulder dislocation in elderly patients,artificial shoulder arthroplasty has the advantages of shorter time,less bleeding and fewer postoperative complications,and should be widely promoted.