骨质疏松性肱骨近端骨折治疗的研究进展

Research progress of the treatment of osteoporotic proximal humeral fractures

肱骨近端骨折变得越来越常见,特别是好发于伴有骨质疏松的老年患者,严重威胁老年人的生活质量。复杂且多变骨折类型是肱骨近端骨折治疗的难点。为了减少失败率,选择合理治疗措施非常重要,目前随着治疗方式的不断变化,可以选择的治疗方案主要包括非手术治疗、髓内钉固定、切开复位钢板内固定,半肩关节置换和反式肩关节置换。手术治疗要求解剖复位和稳定固定,但在骨质疏松患者很难做到。髓内钉固定、切开复位钢板内固定,半肩关节置换和反式肩关节置换都有自己的优势和不足,仍存在争议。本文对骨质疏松性肱骨近端骨折的治疗进行系统性的阐述。

Proximal humeral fractures(PHFx) are increasingly common injuries,especially afflicting elderly osteoporotic patients,which seriously threatens the quality of life of the elderly.Challenges in the treatment of proximal humeral fractures are complex and the variety of fracture patterns complicates classification.To prevent failures,it is essential to choose the most suitable treatment.PHFx treatment paradigms are evolving,with available options including nonoperative treatment,intramedullary nail,open reduction and internal fixation(ORIF),hemiarthroplasty(HA),and reverse total shoulder arthroplasty(RTSA).Surgical treatment requires anatomic reduction and stable fixation,proving difficult,particularly in osteoporotic bone.ORIF,IMN,HA,and RTSA for PHFx have distinct risks and benefits.so the optional of treatments is still controversy.This article described the treatment of osteoporotic proximal humerus fractures.