内侧柱支撑重建辅助治疗对老年肱骨近端骨折患者肢体功能恢复的影响

Effect of Medial Column Support Reconstruction Adjuvant Therapy on the Recoveryof Limb Function in Elderly Patients with Proximal Humeral Fractures

目的分析内侧柱支撑重建辅助治疗对老年肱骨近端骨折患者肢体功能恢复的影响。方法选择2018年1月~2019年5月在我院治疗的老年肱骨近端骨折患者142例,采用随机数字量表分为对照组和观察组,各71例。对照组采用常规内固定术治疗,观察组在对照组基础上联合内侧柱支撑重建术辅助治疗,比较两组临床手术指标(骨折愈合时间、完全负重时间、住院时间)、术后6个月观察比较两组关节功能指标(Neer评分、CMS评分、Brobery-Morrey评分)和关节活动度(前屈上举、前屈外举、前屈外旋、内翻以及肱骨颈干角度)。结果观察组骨折愈合时间、完全负重时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组Neer、CMS、Brobery-Morrey评分均高于对照组,差异有统计学意义(P<0.05);观察组关节前屈上举、前屈外举、前屈外旋、内翻以及肱骨颈干角度均优于对照组,差异有统计学意义(P<0.05)。结论内侧柱支撑重建辅助治疗可促进老年肱骨近端骨折愈合,改善肢体功能,提高关节活动度。

Objective To analyze the influence of medial column support reconstruction adjuvant therapy on the recovery of limb function in elderly patients with proximal humeral fractures.Methods A total of 142 elderly patients with proximal humeral fractures treated in our hospital from January 2018 to May 2019 were selected and divided into a control group and an observation group using a random number scale,with 71 cases in each group.The control group was treated with conventional internal fixation,and the observation group was combined with medial column support reconstruction on the basis of the control group.The clinical operative indicators(fracture healing time,full weight bearing time,hospitalization time)and 6-month observation were compared between the two groups the two groups of joint function indexes(Neer score,CMS score,Brobery-Morrey score)and joint range of motion(flexion-uplift,flexion-external lift,flexion-external rotation,varus and humeral neck shaft angle)were compared between the two groups.Results The fracture healing time,full weight bearing time,and hospitalization time in the observation group were shorter than those in the control group,the difference was statistically significant(P<0.05);Neer,CMS,and Brobery-Morrey scores in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05);The observation group was better than the control group with flexion-uplift,flexion-external lift,flexion-external rotation,varus and humeral neck shaft angles,the difference was statistically significant(P<0.05).Conclusion Adjuvant treatment with medial column support reconstruction could promote the healing of proximal humeral fractures in the elderly,improve limb function,and increase joint mobility.