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老年移位性孤立大结节骨折采用钢板内固定治疗。

Displaced isolated greater tuberosity fractures of elder adults treated with plate osteosynthesis.

机构信息

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Department of Nursing, National Yang-Ming University and Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2019 Apr;82(4):318-321. doi: 10.1097/JCMA.0000000000000049.

Abstract

BACKGROUND

We elucidated the effect of open reduction and internal fixation with locking plate for acute isolated displaced greater tuberosity fractures of humerus in elder adults (aged >60 years).

METHODS

From 2009 to 2015, data from 32 patients, aged between 60 and 88 years, who had acute unilaterally displaced greater tuberosity fractures of humerus were collected and evaluated retrospectively. All the fractures were managed with open reduction and internal fixation with locking plate. The follow-up period was 50.8 months on an average (range 22-80 months). Finally, 25 patients were available for final evaluation of radiographic and functional results.

RESULTS

All the 32 fractures had union with the average union time of 14 weeks (range 10-18 weeks) and with no complications. The average of preoperative Visual Analogue Scale (VAS) was 6.2 (range 4-8), ASES was 30.4 (range 13-45), and Constant score was 30.4 (range 20-45). At the last follow-up, the mean VAS was 1.3 (range 0-2.5), the mean ASES score was 90.1 (range 72-100), and the mean Constant score was 90.3 (range 80-100). There were statistically significant differences between preoperative and final follow-up in VAS, ASES, and Constant score. Hundred percent of patients had good or excellent results by Constant score, with excellent results (86-100) in 17 (68%) patients and good result (71-85) in 8 (32%).

CONCLUSION

In conclusion, open reduction and internal fixation with locking plate is an effective treatment for acute displaced greater tuberosity fractures of humerus in elder adults.

摘要

背景

我们阐明了切开复位锁定钢板内固定治疗老年(>60 岁)急性孤立性移位性肱骨大结节骨折的效果。

方法

回顾性收集 2009 年至 2015 年 32 例年龄在 60 至 88 岁之间的急性单侧移位性肱骨大结节骨折患者的资料。所有骨折均采用切开复位锁定钢板内固定治疗。随访时间平均为 50.8 个月(范围为 22-80 个月)。最终,25 例患者可进行影像学和功能结果的最终评估。

结果

所有 32 例骨折均愈合,平均愈合时间为 14 周(范围为 10-18 周),无并发症。术前视觉模拟评分(VAS)平均为 6.2(范围为 4-8),美国肩肘外科协会评分(ASES)为 30.4(范围为 13-45),Constant 评分为 30.4(范围为 20-45)。末次随访时,VAS 平均为 1.3(范围 0-2.5),ASES 评分为 90.1(范围 72-100),Constant 评分为 90.3(范围 80-100)。VAS、ASES 和 Constant 评分在术前和末次随访时均有统计学差异。根据 Constant 评分,所有患者均有良好或优结果,其中 17 例(68%)为优(86-100),8 例(32%)为良(71-85)。

结论

综上所述,切开复位锁定钢板内固定治疗老年急性移位性肱骨大结节骨折是一种有效的治疗方法。

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