锁定钢板内固定联合植骨在老年肱骨近端骨折患者治疗中的应用研究

目的探究锁定钢板内固定联合植骨在老年肱骨近端骨折患者治疗中的应用。 方法将2017年5月至2019年5月入住本院接受治疗的68例老年肱骨近端骨折患者作为本次的研究对象，依据采用治疗方式的不同分为研究组与对照组，每组患者34例。对照组患者采用普通的钢板内固定术；研究组患者采用锁定钢板内固定联合植骨的治疗方式。比较两组患者的视觉模拟评分（visual analogue scale，VAS）、SF-36评分以及肩功能评分，比较两组患者的治疗效果、手术时间、术中出血量以及住院时间，比较两组患者并发症的发生及术后肱骨头内翻畸形的发生情况。 结果术后3个月，研究组患者的VAS评分与对照组比较显著较低，SF-36评分与肩功能评分显著高于对照组（P<0.05）；研究组患者的优良率与对照组比较显著较高（P<0.05）；研究组患者的手术时间以及住院时间与对照组比较显著较短，术中出血量显著少于对照组（P<0.05）；研究组患者并发症的总发生率与对照组比较显著较低（P<0.05）；研究组内翻畸形发生率显著少于对照组（P<0.05）。 结论在老年肱骨近端骨折患者临床诊疗的过程中，采用锁定钢板内固定联合植骨治疗，能够有效降低患者的疼痛程度，显著改善患者的生活质量状况，对于患者肩功能的恢复有积极的促进作用，同时能够减少并发症及内翻畸形情况出现，利于患者预后。

Application of locking plate internal fixation combined with bone grafting in the treatment of elderly patients with proximal humeral fractures

BackgroundIn clinical treatment, proximal humeral fracture is a relatively common type of fracture, especially in the elderly population. The osteoporosis of elderly patients is more serious, which brings many difficulties to the clinical treatment, leading to invalid conservative treatment. In the process of traditional conservative treatment, patients may suffer from complications such as pain, infection, poor prognosis, and skin necrosis around the incision. Some patients with severe conditions may develop into joint dysfunction and persistent pain, which has a high disability rate. Currently, open reduction and internal fixation is the main treatment method, but the application of simple plate often leads to the fixation failure or the occurrence of fracture relocation, as well as postoperative complications. In recent years, locking plate fixation combined with bone grafting has been gradually applied in the treatment of elderly proximal humeral fractures, while there are relatively few reports. ObjectiveTo explore the application of locking plate combined with bone grafting in the treatment of elderly proximal humeral fractures. MethodsFrom May 2017 to May 2019, a total of 68 elderly patients with proximal humerus fractures admitted to our hospital were selected as the subjects of this study. According to different treatment methods, they were equally divided into the research group and the control group. Patients in the control group were treated with conventional plate fixation, while patients in the research group were treated with locking plate fixation combined with bone grafting. The VAS score, SF-36 score and shoulder function score of two groups were compared, as well as the treatment effect, operation time, intraoperative blood loss and hospital stay. The occurrence of complications and postoperative varus deformity of humeral head in the two groups were compared as well. ResultsThree months after surgery, the VAS score of the research group was significantly lower than that of the control group, and the SF-36 score and shoulder function score were significantly higher than that of the control group (P<0.05) . The excellent and good rate of the research group was significantly higher than that of the control group (P<0.05) . The duration of surgery and hospitalization in the research group was significantly shorter than that in the control group, and the intraoperative blood loss was significantly less than that in the control group (P<0.05) . The overall incidence of complications in the research group was significantly lower than that in the control group (P<0.05) . The incidence of varus deformity in the research group was significantly less than that in the control group (P<0.05) . ConclusionIn the process of clinical diagnosis and treatment of elderly proximal humeral fractures, locking plate fixation with bone grafting can effectively reduce the level of pain and significantly improve the patient’s quality of life. It has a positive role in promoting the recovery and reduce the occurrence of complications and varus deformity, which is conducive to the prognosis of patients.