摘要
目的肱骨近端骨折是老年患者最常见的上臂骨质疏松性骨折,属肩关节骨折,其治疗效果直接影响肩关节的生理功能。文中探讨肱骨近端锁定接骨板（locking proximal humerus plate,LPHP）结合抗骨质疏松药物治疗老年骨质疏松性肱骨近端粉碎性骨折的疗效。方法收集2009年4月至2012年3月间在新疆医科大学第一附属医院骨科接受手术治疗且具有完整随访资料的47例老年骨质疏松性肱骨近端粉碎性骨折患者。根据是否使用抗骨质疏松药物分为2组,即LPHP治疗组23例,其中3部分骨折13例、4部分骨折10例;LPHP＋抗骨质疏松药物治疗组（联合组）24例,其中3部分骨折13例、4部分骨折11例。结果 47例患者获得随访14~38（平均23.6）个月。联合组骨折愈合时间[（96.57±2.59）d]低于LPHP治疗组[（115.91±2.73）d];优良率（91.7%）高于LPHP治疗组（78.3%）,差异均有统计学意义（P〈0.05）。结论与单纯LPHP治疗相比,结合抗骨质疏松药物治疗老年骨质疏松性肱骨近端粉碎性骨折具有固定可靠、骨折愈合时间短、优良率高等优点,加上适时积极的康复锻炼是目前治疗该类骨折较为适用的方法。
Objective Proximal humerus fracture is the most common upper-arm osteoporotic fracture in elderly patients and the result of treatment directly affects the physiological function of the shoulder.This article discusses the clinical effect of the locking proximal humeral plate（ LPHP） combined with anti-osteoporosis drugs in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients.Methods This study included of 47 elderly osteoporotic patients with comminuted proximal humerus fractures treated from April 2009 to March 2012 and with complete follow-up data.According to the Neer classification,the patients were divided into groups A（ LPHP treatment,n = 23,including 13 cases of three-part fractures and 10 cases of four-part fractures）and B（ LPHP ＋ anti-osteoporosis drugs,n = 24,including 13 cases of three-part fractures and 11 cases of four-part fractures）.Results All the patients were followed up for 14 to 38（ mean 23.6） months.The postoperative healing time was significantly shorter in group B than in group A（ [96.57 ± 2.59]d vs [115.91 ± 2.73]d,P ＆lt; 0.05）,and the excellence rate was remarkably higher in B than in A（ 91.7% vs 78.3%,P ＆lt; 0.05）.Conclusion With the advantages of short healing time and high excellence rate,LPHP ＋ anti-osteoporosis drugs is superior to simple LPHP in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients.
出处
《医学研究生学报》
CAS
北大核心
2014年第6期619-622,共4页
Journal of Medical Postgraduates
关键词
锁定接骨板
肱骨近端骨折
骨质疏松
老年人
Locking plate
Proximal humerus fracture
Osteoporosis
Elderly patient
