老年肱骨远端骨折的治疗选择

老年患者肱骨远端骨折常因骨质疏松而致关节面严重粉碎,治疗十分困难。由于全肘关节置换有一定的使用年限,对于活动量较大的成年人,内固定仍是主要的选择,但是对于老年患者,究竟应该选择内固定还是进行全肘关节置换,始终是一个充满争议的话题。在过去几十年,肱骨远端骨折的处理有了很大的进步,其主要进展包括双钢板固定的提出、三维CT重建的广泛应用、对更复杂的关节面剪切骨折的认识、平行钢板技术的理解、关节周围解剖钢板的应用以及全肘关节置换术的选择性应用。本文对国内外的相关文献进行回顾,对老年肱骨远端骨折患者的治疗选择做一综述。

Choices to treat fracture of distal humerus in the elderly patients

Fractures of distal humerus in elderly patients are difficult to treat,as diminished bone mineral quality and increased trauma-associated articular surfaces destruction may make stable joint reconstruction even more difficult. In active patients,internal fixation is still a primary choice because of use age of total elbow replacement,but disagreements have still existed on how to treat these fractures in elderly patients. In the past years,treatment of fractures of distal humerus make much progress,including the introduction of dual plates fixation,widespread application of three-dimensional CT reconstruction,recognition of complicated fractures,understanding of the parallel plate technique,application of periarticular plates,and the selective use of total elbow arthroplasty. This article is an overview in treating options of fracture of distal humerus in the elderly patients by review the civil and overseas involved literatures.