肱骨近端骨折术后皮质支撑方式对患者功能预后的影响

The effect of pattern of cortical support on functional prognosis in patients with proximal humeral fractures

目的比较肱骨近端骨折手术后内侧皮质支撑方式,通过记录患者的功能预后来确定内侧皮质的支撑方式是否对患者术后功能恢复产生影响。方法选择老年肱骨近端内侧柱非粉碎骨折87例,阳性支撑组38例,阴性支撑组49例,术后评估Oxford肩关节评分(Oxford shoulder score,OSS)、臂、肩、手评分(disabilities of arm,shoulder and hand,DASH)以及疼痛评分(visual analogue scale,VAS)评分。结果手术后6个月随访阳性支撑组和阴性支撑组的OSS、DASH以及VAS评分结果差异无统计学意义(P>0.05);12个月随访后,OSS、DASH以及VAS评分结果差异也无统计学意义(P>0.05)。结论肱骨近端手术后,如果出现阳性支撑或者阴性支撑,也不会显著地影响内侧柱非粉碎患者的术后功能预后,因此对肱骨近端这一非负重关节,原则上内侧皮质支撑尽量达到解剖复位,但是如果不能达到,也不会对功能预后造成严重影响。

Objective To compare different medial cortical support patterns after operation for proximal humeral fracture,and to determine the effect of medial cortical support on the functional recovery by recording functional prognosis.Methods A total of 87 patients with proximal humeral fracture(non-comminuted fracture ofmedial column)were enrolled,including 38 patients in positive support group,and 49 patients in negative support group.Oxford shoulder score(OSS),disabilities of arm,shoulder and hand(DASH)and visual analogue scale(VAS)scores were evaluated after operation.Results There were no significant differences in OSS,DASH and VAS score in positive and negative cortical support groups at 6 and 12 months after operation.Conclusion After proximal humeral surgery,positive or negative support will not significantly affect the postoperative functional prognosis of patients with non-comminuted fracture of medial column.Therefore,for the non-weight-bearing joint of the proximal humerus,medial cortical support should permit anatomical reduction.If not,short-term follow-up shows that it will not have a serious impact on the functional prognosis.