Dai Zhang-sheng, Huang Jie-miao, Zhuang Xun-rong, Chen Shou-bo, Wu Shi-qiang, Yao Xue-dong, Ye Hui
Zhongguo Gu Shang. 2014 Dec;27(12):1015-8.
To explore clinical effects of suturing-assisted locking plate in treating elderly proximal humeral fractures.
From January 2005 to January 2013, 55 elderly patients with three- and four-part fractures of proximal humeral fractures were divided into treatment group and control group. In treatment group, there were 31 patients including 12 males, and 19 females aged from 65 to 85 with an average of (74.00±5.42) years old, and treated with suturing-assisted locking plates; 19 patients were Neer 3-part fractures, and 12 patients were Neer 4-part fractures of proximal humerus; 23 patients were suffered from low-energy injuries and 8 patients were caused by high-energy injuries. In control group, there were 24 patients including 7 males, and 17 females aged from 65 to 85 with an average of (72.79±5.34) years old, and treated with locking plates; 16 patients were Neer 3-part fractures, and 8 patients were Neer 4-part fractures of proximal humerus; 17 patients were suffered from low-energy injuries and 7 patients were caused by high-energy injuries. Operative time, blood loss during operation, and bone healing time between two groups were observed and compared. Postoperative Neer scoring were used to evaluate recovery of shoulder joint function.
All patients were followed up from 6 to 24 months with an average of 16.1 months. In treatment group, blood loss was (495.806±143.150) ml, function of Neer scoring was 22.645±2.443, range of action was 18.194±2.613, anatomy was 7.935±1.504 and total score of Neer scoring was 77.161±8.335; while in control group, blood loss was (641.667±169.851) ml, function of Neer scoring was 13.958±1.989, range of action was 13.083±2.165, anatomy was 5.500±1.978 and total score of Neer scoring was 58.792±7.313. There were sigificant difference between two groups in these indexes.
Suturing-assisted locking plate for the treatment of proximal humerus fractures in elderly, has advantages of less blood loss, simple fracture reduction and rapid recovery of shoulder joint, and is a effective method.
探讨缝合辅助锁定钢板治疗老年肱骨近端骨折的临床效果。
选取2005年1月至2013年1月期间55例老年肱骨近端三部分和四部分骨折患者，分为治疗组和对照组。治疗组31例，男12例，女19例，年龄65～85岁，平均（74.00±5.42）岁，采用缝合辅助锁定钢板治疗；其中Neer三部分骨折19例，Neer四部分骨折12例；低能量损伤23例，高能量损伤8例。对照组24例，男7例，女17例，年龄65～85岁，平均（72.79±5.34）岁，采用锁定钢板治疗；其中Neer三部分骨折16例，Neer四部分骨折8例；低能量损伤17例，高能量损伤7例。观察比较两组手术时间、术中出血量及骨折愈合时间。采用术后Neer评分评价肩关节功能恢复情况。
所有患者均获随访，随访时间6～24个月，平均16.1个月。治疗组术中出血量为（495.806±143.150）ml，Neer评分中功能为22.645±2.443，活动范围为18.194±2.613，解剖为7.935±1.504，Neer评分总分77.161±8.335；对照组术中出血量为（641.667±169.851）ml，Neer评分中功能为13.958±1.989，活动范围为13.083±2.165，解剖为5.500±1.978，Neer评分总分58.792±7.313。两组上述指标比较差异有统计学意义。
缝合辅助锁定钢板治疗老年肱骨近端骨折，具有出血量少、骨折复位简单、肩关节恢复快等优点，是一种有效的治疗方法。
