锁定钢板联合药物抗骨质疏松治疗老年肱骨近端粉碎性骨折的临床疗效

The clinical effect of locking proximal humerus plate combined with anti-osteoporosis drugs of the elderly patients with comminuted fractures of proximal humerus

目的:探讨锁定钢板联合药物抗骨质疏松治疗老年肱骨近端粉碎性骨折的临床疗效。方法:60例老年肱骨近端粉碎性骨折患者分为对照组及观察组,每组各30例。对照组患者采取肱骨近端锁定钢板手术治疗,观察组在对照组的基础上联合抗骨质疏松药物治疗,疗程≥6个月。分别于术后3个月、术后6个月,采用Constant-Murley评分评估两组患者肩关节功能,测定L2-4椎体骨密度;采用欧洲五维健康量表(EQ-5D)评估术后生活质量,记录术后6个月内并发症发生情况。结果:术后3个月和6个月,观察组患者Constant-Murley评分、EQ-5D健康指数均分别高于对照组(P<0.05)。术后6个月,观察组患者骨密度高于对照组(P<0.05)。术后6个月,观察组患者并发症总发生率低于对照组,差异无统计学意义(P>0.05)。结论:肱骨近端锁定钢板手术联合术后抗骨质疏松药物治疗,有利于促进老年肱骨近端粉碎性骨折患者肩关节功能恢复、增加骨密度、提高生活质量。

Objective:To investigate the clinical effect of locking proximal humerus plate(LPHP)combined with anti-osteoporosis drugs of the elderly patients with comminuted fractures of proximal humerus.Methods:60 elderly patients with comminuted fractures of proximal humerus were selected as the study objects.They were divided into control group(n=30)and observation group(n=30).The control group was treated with LPHP surgery.The observation group was treated with anti-osteoporosis drugs on the basis of the control group,at least 6 months of treatment.3 months and 6 months after the operation,the shoulder function of the two groups was evaluated by Constant-Murley score,the bone density of L2-4 vertebral body was measured,the quality of life was evaluated by the European five dimensional health scale(EQ-5D),and the complications within 6 months were recorded.Results:At 3 months and 6 months after operation,the Constant-Murley score and EQ-5D health index in the observation group were higher than those in the control group(P<0.05).6 months after operation,the BMD of the observation group was higher than that of the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was not statistically significant(P>0.05).Conclusion:The operation of LPHP combined with postoperative anti-osteoporosis drugs treatment is beneficial to promote the shoulder joint function recovery,increase the bone density and improve the quality of life of the elderly patients with comminuted fractures of proximal humerus.