| 锁定钛板治疗老年肱骨近端粉碎性骨折的病例对照研究 |
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投稿时间：2014-09-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 史政康 |
SHI Zheng-kang |
苏州市吴江区中医医院骨科, 江苏 吴江 215200 |
Department of Orthopaedics, Suzhou City Wujiang Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China |
2531240061@qq.com |
| 蒋元斌 |
JIANG Yuan-bin |
苏州市吴江区中医医院骨科, 江苏 吴江 215200 |
Department of Orthopaedics, Suzhou City Wujiang Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China |
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| 计小东 |
JI Xiao-dong |
苏州市吴江区中医医院骨科, 江苏 吴江 215200 |
Department of Orthopaedics, Suzhou City Wujiang Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China |
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| 晋存 |
JIN Cun |
苏州市吴江区中医医院骨科, 江苏 吴江 215200 |
Department of Orthopaedics, Suzhou City Wujiang Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China |
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| 期刊信息：《中国骨伤》2014年，第27卷，第12期，第986-990页 |
| DOI：10.3969/j.issn.1003-0034.2014.12.003 |
| 基金项目: |
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中文摘要:
目的: 观察锁定钛板治疗老年肱骨近端粉碎性骨折的临床疗效.
方法: 2011年6月至2013年5月收治72例老年肱骨近端粉碎性骨折,分为锁定钛板组(36例)和解剖钛板组(36例).锁定钛板组男16例,女20例;年龄60～79岁,平均 (69.55±5.62)岁;NeerⅡ型10例,Ⅲ型18例,Ⅳ型8例;采用肱骨近端解剖锁定钛板内固定治疗.解剖钛板组男15例,女21例;60～81岁,平均 (69.76±5.70)岁;NeerⅡ型9例,Ⅲ型20例,Ⅳ型7例;采用解剖钛板内固定治疗.观察两组患者的临床疗效、治疗前后Neer评分、手术时间、骨折愈合时间、并发症发生率等.
结果: 72例患者均获得随访,时间1～3年,平均15个月.锁定钛板组治疗优良率为91.7%,明显高于解剖钛板组75.0%(P<0.05);两组治疗后Neer评分均有显着提高(P<0.05),但锁定钛板组提高水平明显优于解剖钛板组,分别为(92.51±7.85)分和(83.64±8.56)分(P<0.05);两组在手术时间上比较差异无统计学意义(P>0.05);锁定钛板组骨折愈合时间为(18.6±3.4)周,明显少于解剖钛板组(24.3±3.9)周(P<0.05);锁定钛板组并发症发生率为5.6%,明显低于解剖钛板组22.2%(P<0.05).
结论: 肱骨近端解剖锁定钛板治疗老年肱骨近端粉碎性骨折在优良率、Neer评分及骨愈合时间上有明显优势,且患者可早期康复锻炼,肩关节疼痛少,肩关节功能恢复更好,并发症少,安全有效,值得临床推广应用,尤其对老年骨质疏松患者. |
| 【关键词】肱骨骨折,近端 骨折,粉碎性 骨折固定术 病例对照研究 |
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| Case-control study on locking titanium plate in treating comminuted proximal humeral fracture in elderly |
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ABSTRACT
Objective: To observe therapeutic effects of locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly.
Methods: From June 2011 to May 2013, 72 elderly patients with comminuted proximal humeralfractures were divided into locking titanium plate group and anatomical plate group,36 cases in each group. In locking titanium plate group,there were 16 males and 20 females aged from 60 to 79 years old with an average of (69.55±5.62) years old;10 cases were type Neer Ⅱ,18 were type Neer Ⅲ and 8 cases were type Neer Ⅳ in accordance with Neer classification;treated with locking titanium plate. In anatomical plate group,there were 15 males and 21 females aged from 60 to 81 years old with an average of (69.76±5.70) years old;9 cases were type Neer Ⅱ,20 were type Neer Ⅲ and 7 cases were type Neer Ⅳ;and treated with anatomical plate. Clinical effects,preoperative and postoperative Neer scoring,operative time,bone healing time and incidence of complications between two groups were compared.
Results: All patients were followed up from 1 to 3 years with an average of 15 months. The excellent and good rate of locking titanium plate group (91.7%) was significantly higher than anatomical plate group(75.0%). Postoperative Neer score of two groups were improved obviously,but locking titanium plate group(92.51±7.85) was higher than anatomical plate group (83.64±8.56);there was no significant differences between two groups in operative time(P>0.05);bone healing time in locking titanium plate was(18.6±3.4) weeks,and shorter than anatomical plate group(24.3±3.9) weeks;incidence of complications in locking titanium plate was(5.6%) shorter than anatomical plate group (22.2%),and had obviously differences between two groups.
Conclusion: Locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly plays an important role in good rate,bone healing time and Neer score. It has advantages of early rehabilitation exercise,less shoulder pain,rapid recovery of shoulder joint,less complications,safe and effective,and be worthy of clinical application,especially for senile osteoporosis patients. |
| KEY WORDS Humeral fractures,proximal Fractures,comminuted Fracture fixation Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 史政康,蒋元斌,计小东,晋存.锁定钛板治疗老年肱骨近端粉碎性骨折的病例对照研究[J].中国骨伤,2014,27(12):986~990 |
| 英文格式: | SHI Zheng-kang,JIANG Yuan-bin,JI Xiao-dong,JIN Cun.Case-control study on locking titanium plate in treating comminuted proximal humeral fracture in elderly[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(12):986~990 |
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