肱骨近端锁定钢板内固定治疗老年骨质疏松性骨折

Treatment of senile osteoporotic fracture with proximal locking plate internal fixation

目的比较人工肱骨头置换术与肱骨近端锁定钢板内固定治疗老年骨质疏松性肱骨近端骨折的疗效。方法88例老年骨质疏松性肱骨近端骨折患者随机分为观察组(n=45例)和对照组(n=43例),观察组实施肱骨近端锁定钢板内固定术治疗,对照组实施人工肱骨头置换术治疗。术后随访6个月,比较两组患者手术相关指标、Constant-Murley肩关节功能评分(CMS)、临床疗效及并发症发生率。结果对照组术后住院时间、术中出血量、切口长度、手术时间、并发症发生率分别为(14.2±4.3)d、(169±25)mL、(9.2±1.5)cm、(68.3±7.2)min、23.26%,观察组分别为(10.1±3.1)d、(195±27)mL、(13.7±2.3)cm、(87.5±6.8)min、11.11%,两组比较差异均有统计学意义(均P<0.05)。在术后引流量、CMS和临床疗效上两组差异均无统计学意义。结论老年骨质疏松性骨折患者采用肱骨近端锁定钢板内固定术治疗术后恢复快,并发症发生率低。

Objective To compare the efficacy of artificial humeral head replacement and proximal humeral locking plate fixation in the treatment of senile osteoporotic proximal humeral fractures.Methods Eighty-eight elderly patients with osteoporotic proximal humeral fractures were randomly divided into observation group(n=45)and control group(n=43).The observation group was treated with proximal humeral locking plate internal fixation,and the control group was treated with artificial humeral head replacement.The patients were followed up for 6 months.The operation related indexes,Constant-Murley shoulder function score(CMS),clinical efficacy and incidence of complications were compared between the two groups.Results The postoperative hospital stay,intraoperative blood loss,incision length,operation time and complication rate of the control group were(14.2±4.3)d,(169±25)mL,(9.2±1.5)cm,(68.3±7.2)min and 23.26%,respectively,while those of the observation group were(10.1±3.1)d,(195±27)mL,(13.7±2.3)cm,(87.5±6.8)min and 11.11%,respectively,with significant differences between the two groups(all P<0.05).There were no significant differences in postoperative drainage volume,CMS and clinical efficacy between the two groups.Conclusion Elderly patients with osteoporotic fractures treated with proximal humeral locking plate fixation,postoperative recovery is fast,the incidence of complications is low.