【摘要】 目的探讨肱骨近端锁定钢板治疗老年肱骨近端骨折患者的临床疗效,分析并发症发生原因并提出预防处理方法。方法回顾性分析2013年1月至2017年1月云浮市人民医院采用肱骨近端锁定钢板内固定治疗的31例老年肱骨近端骨折患者的临床资料。根据Neer肩关节功能评分评估手术疗效,观察术后并发症发生情况。结果随访时间10~22个月,平均随访时间(12.6±8.3)个月。末次随访时根据Neer肩关节功能评分标准,优12例、良13例、可4例、差2例,优良率81%。术后出现2例肱骨头坏死、1例骨折端再移位、1例螺钉穿出关节面、2例骨折延期愈合。结论肱骨近端锁定钢板治疗老年肱骨近端骨折手术时间短、损伤小,患者术后肩关节功能恢复满意;但仍存在一定并发症,要求术者做好充分的术前评估,熟练掌握手术技术,加强早期功能康复锻炼,以尽可能降低术后并发症的发生率。更多还原

【Abstract】 Objective To explore the clinical effects of proximal humerus locking plate for treating elderly patients with proximal humerus fractures, and to analyze the causes of complications and to provide the prevention and countermeasures. Methods Clinical data of 31 elderly patients with proximal humerus fractures treated by proximal humerus locking plate from January 2013 to January 2017 in Yunfu People’s Hospital were retrospectively analyzed. Therapeutic effects were evaluated according to Neer shoulder function score, and the postoperative complications were observed. Results The follow-up time was 10 to 22 months, with the average time of(12.6 ± 8.3) months. According to Neer shoulder function scoring criteria, there were excellent in 12 cases, good in 13, fair in 4 and poor in 2, with the excellent and good rate of 81% at the last follow-up.Postoperative complications included 2 cases of humeral head necrosis, 1 case of fracture displacement, 1 case of screw penetration of the articular surface, and 2 cases of delayed healing. Conclusions For elderly patients with proximal humeral fractures, proximal humerus locking plate has the advantages of short operation time, minor injury and satisfactory recovery of shoulder function; but certain postoperative complications still exist, which need the surgeons to evaluate the patients before the surgery adequately, grasp the surgical skills proficiently, and encourage patients keeping early function exercises actively, so as to reduce the incidence of complications as far as possible.更多还原