老年肱骨近端骨折的诊治现状与进展

Diagnosis and treatment of proximal humeral fractures in the elderly

一、肱骨近端骨折(proximal humeral fractures,PHFs)的流行病学PHFs的流行病学研究对本病的预防以及在预测其患病率上至关重要。然而,关于PHFs的中远期流行病学研究的相关报道较少[1]。据文献报道,PHFs的发病率占全身骨折的4%~9%,与老龄化程度成正相关,呈逐年上升的趋势,具有明显的季节性变化,冬季高发[2-3]。在年龄>65岁的老年人中,其发病率仅次于髋部及桡骨远端骨折,是老年人中第三常见的骨折类型[4]。PHFs的发病年龄呈双峰分布,30岁左右的青年和60岁以上的老年人[5],而老年人为发病的高危人群,这与老年人钙量丢失、骨质疏松及低能量损伤等因素有关[6]。

Proximal humeral fractures(PHFs)are common in orthopedics,especially in elderly women.Its incidence rate in the elderly has increased in recent years with the aging in China,which is the third most common fracture in the elderly following distal radius and hip fractures.At present,the treatment of elderly PHFs includes nonsurgical management,open reduction and internal fixation(ORIF),hemiarthroplasty(HA)and reverse total shoulder arthroplasty(RTSA),etc.Different treatment methods have different clinical effects.Therefore,this paper reviews the treatment progress of elderly PHFs at home and abroad,in order to provide references for its treatment.