Shi Zheng-kang, Jiang Yuan-bin, Ji Xiao-dong, Jin Cun
Zhongguo Gu Shang. 2014 Dec;27(12):986-90.
To observe therapeutic effects of locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly.
From June 2011 to May 2013, 72 elderly patients with comminuted proximal humeral- fractures 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.
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.
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.
观察锁定钛板治疗老年肱骨近端粉碎性骨折的疗效。
选取2011年6月至2013年5月间72例老年肱骨近端粉碎性骨折患者，分为锁定钛板组和解剖钢板组，每组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；按Neer分型：NeerⅡ型10例，NeerⅢ型18例，NeerⅣ型8例；采用锁定钛板治疗。解剖钢板组男15例，女21例，年龄60～81岁，平均（69.76±5.70）岁；NeerⅡ型9例，NeerⅢ型20例，NeerⅣ型7例；采用解剖钢板治疗。比较两组临床疗效、术前及术后Neer评分、手术时间、骨折愈合时间及并发症发生率。
所有患者随访1～3年，平均15个月。锁定钛板组优良率（91.7%）明显高于解剖钢板组（75.0%）。两组术后Neer评分均明显改善，但锁定钛板组（92.51±7.85）高于解剖钢板组（83.64±8.56）；两组手术时间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，短于解剖钢板组（24.3±3.9）周；锁定钛板组并发症发生率（5.6%）低于解剖钢板组（2个2%），两组比较差异有统计学意义。
锁定钛板治疗老年肱骨近端粉碎性骨折在优良率、骨折愈合时间及Neer评分方面具有重要作用。具有早期康复锻炼、肩部疼痛轻
