高龄肱骨近端骨折术后肱骨头坏死的影响因素分析

Influencing Factors of Humeral Head Necrosis after Proximal Humeral Fracture in Elderly Patients

目的:分析高龄肱骨近端骨折术后肱骨头坏死的影响因素。方法:随机选取2014年5月～2017年5月某院骨科收治的高龄肱骨近端骨折患者40例,所有患者均接受切开复位锁定钢板内固定手术治疗,对其术后肱骨头坏死进行单因素和多因素Logistic回归分析。结果:单因素Logistic回归分析显示,高龄肱骨近端骨折术后肱骨头坏死的影响因素包括Neer分型、植骨、复位程度、肱骨头螺钉数目、内侧柱重建、内侧柱粉碎、内侧柱粉碎×内侧柱支撑(P<0.05);多因素Logistic回归分析显示,高龄肱骨近端骨折术后肱骨头坏死的影响因素包括Neer分型、内侧柱粉碎(P<0.05)。结论:高龄肱骨近端骨折术后肱骨头坏死的影响因素包括Neer分型、内侧柱粉碎。

Objective:To analyze the influencing factors of humeral head necrosis after proximal humeral fracture in elderly patients.Methods:40 elderly patients with proximal humerus fractures admitted to the department of orthopedics of a hospital from May 2014 to May 2017 were randomly selected.All patients were treated with open reduction locking plate internal fixation,and the univariate and multivariate Logistic regression analysis of postoperative humerus head necrosis was performed.Results:Univariate Logistic regression analysis showed that the influencing factors of humeral head necrosis after proximal humeral fracture in elderly patients included Neer classification,bone grafting,degree of reduction,number of humeral head screws,reconstruction of medial column,crushing of medial column,and crushing of medial column multiply internal column support ( P <0.05);Multivariate Logistic regression analysis showed that the influential factors of humeral head necrosis after proximal humeral fracture in elderly patients included Neer classification and medial column comminuting ( P <0.05).Conclusion:Neer classification and medial column comminuting are the influential factors of humeral head necrosis after proximal humeral fracture in elderly patients.