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老年肱骨近端骨质疏松性骨折的临床治疗策略
引用本文:张治宇,苑福升,李力卓,胡硕,高志学.老年肱骨近端骨质疏松性骨折的临床治疗策略[J].临床军医杂志,2011,39(3).
作者姓名:张治宇  苑福升  李力卓  胡硕  高志学
作者单位:1. 中国医科大学附属第四医院,辽宁,沈阳,110034
2. 中国医科大学附属盛京医院,辽宁,沈阳,110030
3. 解放军第二军医大学长海医院,骨科,上海,200433
4. 中国医科大学北京顺义医院,北京,100000
基金项目:辽宁省自然科学基金资助项目
摘    要:目的探讨老年肱骨近端骨质疏松性骨折的治疗方法与疗效。方法本组病例收集自2003年3月—2010年3月,共51例,其中男22例,女29例,年龄55~74岁,平均(63.6±7.4)岁。按Neer分型:二部分骨折21例,单纯三部分骨折18例,三部分合并关节脱位3例,单纯四部分骨折9例。其中2例三部分骨折合并关节脱位及7例四部分骨折采用半肩关节置换术,其余均采用锁定加压钢板内固定治疗。随访时间5~34个月,平均(17.6±6.4)个月。结果患者分别按Neer肩关节功能评分标准评估,未见显著性差异。结论锁定加压钢板内固定术是治疗老年肱骨近端骨质疏松性骨折有效选择之一,半肩关节置换为复杂肩关节损伤提供了一个有效的治疗手段。

关 键 词:老年肱骨近端骨折  骨质疏松  半肩关节置换  锁定加压钢板

Surgical Treatment for senile osteoporotic fracture
Zhang Zhi-yu,Yuan Fu-sheng,Li Li-zhuo,Hu Shuo,Gao Zhi-xue.Surgical Treatment for senile osteoporotic fracture[J].Clinical Journal of Medical Officer,2011,39(3).
Authors:Zhang Zhi-yu  Yuan Fu-sheng  Li Li-zhuo  Hu Shuo  Gao Zhi-xue
Institution:Zhang Zhi-yu1,Yuan Fu-sheng1,Li Li-zhuo2,Hu Shuo3,Gao Zhi-xue4(1.Department of Orthopedics,Fourth Affiliated Hospital of China Medical University,Shenyang Liaoning 110032,China,2.Department of Hand Surgery,Shenjing Hospital of China Medical University,Shenyang Liaoning 110034,3.Department of Orthopedics,Changhai Hospital of Second Military Medical University,PLA,Shanghai 200433,4.Department of Orthopedics,Shunyi Hospital of China Medical University,Beijing 100031,China)
Abstract:Objective To discuss the operative technique and treatment effect of senile osteoporotic fracture of the proximal humerus with locking compression plate.Methods A group of 51 cases with senile osteoporotic fracture of the proximal humerus were treated with LCP or Hemi-arthroplasty.Among 51 patients,there were 22 males and 29 females,aged 55~74 years and a mean age of(63.6±7.4) years.Neer fracture classification and rating system were used to appraise the trauma and therapeutic effect.There were 21 patients had two parts fracture,18 patients had simple three parts fracture,3 patients had three parts fracture combined with shoulder dislocation and 9 patients had four parts fracture.All cases were followed up for 5 to 34 months,average(17.6±6.4)months.Results The clinical results were satisfied according to the Neer,Oxford evaluations and no obvious statistics differences were found between the two groups.Conclusion LCP would be an effective choice in the treatment of complex senile osteoporotic fracture of the proximal humerus,Hemi-arthroplasty is a good choice for Neer 4 complex senile osteoporotic fracture.
Keywords:senile proximal humeral fracture  osteoporosis  Hemi-arthroplasty  locking compression plate  
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