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| “三位一体”骨修复策略治疗老年骨质疏松性肱骨近端骨折的临床疗效 |
| 吴银生1,尤炯鸣1,王勇1*,陈晓2,盛世豪2,张涛2,张磊3 |
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(1. 温州市中西医结合医院骨科, 温州 325000;
2. 海军军医大学(第二军医大学)第一附属医院骨科, 上海 200433;
3. 中国人民解放军联勤保障部队第九〇六医院骨科, 温州 325000
*通信作者) |
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| 摘要: |
| 目的 探讨采用“三位一体”骨修复策略治疗老年骨质疏松性肱骨近端骨折的临床疗效。方法 采用回顾性病例研究，分析2019年4月―2020年5月温州市中西医结合医院收治的28例采用“三位一体”骨修复策略治疗的老年骨质疏松性肱骨近端骨折患者的临床资料。记录患者的骨折愈合时间、颈干角变化。末次随访时采用美国加利福尼亚大学洛杉矶分校（UCLA）肩关节评分评价肩关节功能，记录双侧关节活动度和并发症情况。结果 28例患者中男8例、女20例，年龄为65～86（71.7±6.0）岁；二部分骨折10例，三部分骨折14例，四部分骨折4例；随访时间9～12个月，平均10.5个月。28例患者随访期间均获得骨性愈合，平均愈合时间为（12.6±1.5）周，平均颈干角为（133.1±5.6）°。平均UCLA评分为（31.1±4.1）分。患侧肩关节平均前屈上举、外展、外旋角度分别为（132.5±7.7）°、（116.5±7.0）°、（40.3±3.5）°，内旋至L2/3，与健侧[（169.5±7.3）°、（157.5±6.9）°、（52.1±4.2）°，内旋至T11/12]相比，差异有统计学意义（P＜0.05）。28例患者中1例出现螺钉穿出，并发症发生率为3.6%。结论 采用“三位一体”骨修复策略治疗老年骨质疏松性肱骨近端骨折的骨折愈合率高、手术并发症少、肩关节功能恢复好，临床疗效满意。 |
| 关键词: 肩骨折 骨质疏松性骨折 内固定器 三位一体 |
| DOI：10.16781/j.CN31-2187/R.20220027 |
| 投稿时间：2022-01-09修订日期：2023-03-29 |
| 基金项目: |
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| Efficacy of “three-in-one” bone repair strategy for osteoporotic proximal humeral fractures in elderly patients |
| WU Yinsheng1,YOU Jiongming1,WANG Yong1*,CHEN Xiao2,SHENG Shihao2,ZHANG Tao2,ZHANG Lei3 |
(1. Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou 325000, Zhejiang, China;
2. Department of Orthopaedics, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
3. Department of Orthopaedics, No. 906 Hospital of Joint Logistics Support Force of PLA, Wenzhou 325000, Zhejiang, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the clinical effect of “three-in-one” bone repair strategy in the treatment of osteoporotic proximal humeral fractures in elderly patients. Methods A retrospective case-control study was conducted to analyze the clinical data of 28 elderly osteoporotic patients with proximal humeral fractures treated with “three-in-one” bone repair strategy in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from Apr. 2019 to May 2020. The fracture healing time and neck-trunk angle were recorded. At the last follow-up, shoulder function was evaluated by the University of California Los Angeles (UCLA) shoulder score, bilateral range of motion and complications were observed as well. Results There were 8 males and 20 females, aged 65-86 (71.7±6.0) years. There were 10 patients with Neer’s two-part fracture, 14 three-part fracture, and 4 four-part fracture. All patients were followed up for 9-12 months, with an average of 10.5 months. Bone union was achieved in 28 patients with a mean healing time of (12.6±1.5) weeks and a mean cervix-trunk angle of (133.1±5.6)°. The average UCLA shoulder score was (31.1±4.1). The mean uplift, abduction, and external rotation angles of the injured side shoulder joint were (132.5±7.7)°, (116.5±7.0)°, and (40.3±3.5)°, and the internal rotation reached L2/3. The mean uplift, abduction, and external rotation angles of the healthy side shoulder joint were (169.5±7.3)°, (157.5±6.9)°, and (52.1±4.2)°, and the internal rotation reached T11/12. The difference of range of motion between the 2 sides was statistically significant (P＜0.05). Screw cut-out occurred in 1 patient, with a complication rate of 3.6%. Conclusion For the elderly patients with osteoporotic proximal humeral fracture, “three-in-one” bone repair strategy shows high bone union rate, low surgical complication rate, good recovery of shoulder joint function, and satisfied clinical results. |
| Key words: shoulder fractures osteoporotic fractures internal fixators three-in-one |
