肱骨近端骨折患者术后肩关节功能不良的影响因素

Influencing Factors of Postoperative Shoulder Joint Dysfunction in Patients with Proximal Humeral Fracture

目的分析肱骨近端骨折患者术后肩关节功能不良的影响因素。方法选取2019年1月至2020年5月于商丘市第五人民医院接受手术治疗的152例肱骨近端骨折患者。术后随访1 a。采用肩关节Neer评分法评估患者的肩关节功能,并根据评估结果将患者分为良好组和不良组。记录患者临床资料。采用logistic回归分析影响肱骨近端骨折患者术后肩关节功能的相关因素。结果术后1 a,不良组28例(18.42%),良好组124例(81.58%)。不良组Neer骨折分型、合并神经损伤、合并血管损伤、合并骨质疏松症及复位质量情况与良好组比较,差异有统计学意义(P<0.05)。Neer骨折分型为四部分骨折、合并神经损伤、合并血管损伤、合并骨质疏松症、复位质量不满意均为肱骨近端骨折患者术后肩关节功能不良的危险因素(P<0.05)。结论肱骨近端骨折患者术后肩关节功能不良可能受Neer骨折分型为四部分骨折、合并神经损伤、合并血管损伤、合并骨质疏松症、复位质量不满意等因素的影响。

Objective To analyze the related factors affecting postoperative shoulder joint dysfunction in patients with proximal humeral fracture.Methods A total of 152 patients with proximal humeral fractures who underwent surgical treatment in Shangqiu Fifth People’s Hospital from January 2019 to May 2020 were selected.Follow-up was 1 year after operation.The shoulder joint Neer score method was used to evaluate the shoulder joint function of patients,and the patients were divided into good group and poor group according to the evaluation results.The patients’clinical data were recorded.Logistic regression was used to analyze the related factors affecting the postoperative shoulder joint function in patients with proximal humeral fracture.Results One year after operation,28 cases(18.42%)were in poor group and 124 cases(81.58%)were in good group.Compared with the good group,the Neer fracture classification,nerve injury,vascular injury,osteoporosis and the quality of reduction were statistically different(P<0.05).Four-part fracture of Neer fracture classification,nerve injury,vascular injury,osteoporosis and unsatisfactory reduction quality were all risk factors for postoperative shoulder joint dysfunction in patients with proximal humeral fracture(P<0.05).Conclusion Postoperative shoulder joint dysfunction in patients with proximal humeral fracture may be affected by Neer’s fracture classification as four-part fracture,combined with nerve injury,combined with vascular injury,combined with osteoporosis and unsatisfactory reduction quality.