内侧柱支撑重建与常规内固定治疗老年肱骨近端骨折的疗效比较

Comparison effect of medial column support reconstruction and conventional internal fixation for the treatment of elderly proximal humerus fracture

目的探讨内侧柱支撑重建治疗老年肱骨近端骨折的疗效。方法将110例肱骨近端骨折患者按治疗方法分为固定组(行常规内固定)和支撑组(在常规内固定基础上联合内侧柱支撑重建治疗),每组55例。比较术后两组住院时间、临床愈合时间、完全负重时间、肩关节功能Constant评分、疼痛VAS评分、肱骨头内翻角度、肩关节活动度。结果患者均随访12个月。与固定组相比,支撑组的住院时间、临床愈合时间、完全负重时间均更短(P <0. 01),Constant评分及其优良率更高(P <0. 01),VAS评分更低(P <0. 01),肱骨头内翻角度更小(P <0. 01),肩关节活动度更大(P <0. 01)。结论与常规内固定治疗相比,内侧柱支撑重建治疗老年肱骨近端骨折可迅速改善肩关节功能,提高关节活动度,且缩短愈合时间。

Objective To investigate the effect of medial column support reconstruction in the treatment of proximal humeral fractures in the elderly. Methods A total of 110 patients with tibiofibular fractures were divided into the fixed group (conventional internal fixation) and the support group(conventional internal fixation combined with medial column support reconstruction),55 cases each group. The clinical healing time, total weight-bearing time, hospitalization time, shoulder joint function Constant score, pain VAS, humeral head varus angle and joint mobility were compared between the two groups. Results All patients were followed up for 12 months. Compared with the fixed group, the hospitalization time,the clinical healing time, the time of complete weight-bearing of the support group was shorter ( P <0.01), and Constant score and the excellent-good rate of Constant score were higher ( P <0.01),the VAS was lower ( P <0.01), and the humeral head varus angle was smaller( P <0.01),the joint mobility was greater( P<0.01 ). Conclusions Compared with conventional internal fixation, medial column support reconstruction for the treatment of proximal humeral fractures can improve shoulder function, improve joint mobility, and shorten healing time.