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老年肘部骨折的治疗

Management of Elderly Elbow Fractures.

作者信息

Gupta Ravi, Kapoor Anil

机构信息

Paras Hospital Panchkula, Nana Sahib, Haryana India.

出版信息

Indian J Orthop. 2025 Jan 29;59(3):358-367. doi: 10.1007/s43465-024-01331-z. eCollection 2025 Mar.

Abstract

BACKGROUND

Elbow fractures are common in elderly patients with osteoporotic bones, typically resulting from falls on the elbow. Common fracture types include distal humerus, olecranon, and radial head fractures. Occasionally, a combination of these fractures occurs, creating complex injuries such as terrible triad injuries. Accurate evaluation using X-rays and CT scans is essential for optimal treatment planning. Careful preoperative planning, including the decision between non-operative and operative treatment and selecting appropriate surgical implants, is critical for achieving successful outcomes.

OBJECTIVE

This chapter focuses on common elbow fractures in elderly patients and explores the available treatment options. Given the lack of clear consensus on managing elbow fractures in osteoporotic bones, we address the associated complications and highlight various treatment approaches.

CURRENT KNOWLEDGE

Numerous treatment methods have been proposed for osteoporotic elbow fractures, including various fixation techniques, arthroplasty, and excisions. Despite the availability of multiple treatment options, no method has emerged as superior. Each method has distinct advantages and disadvantages. This chapter aims to compile and compare these options, outlining their respective pros and cons.

CONCLUSIONS

Elbow fractures in osteoporotic bones present significant challenges for surgeons. Although elderly patients with osteoporotic bones generally have lower functional demands compared to younger individuals, they still require adequate, pain-free elbow function for daily activities. Advances in surgical techniques and implant technology have expanded treatment options for these fractures. Achieving successful outcomes requires selecting the appropriate implant, meticulous preoperative planning, and expert surgical execution tailored to the specific fracture characteristics.

摘要

背景

肘部骨折在骨质疏松的老年患者中很常见,通常是由肘部着地摔倒所致。常见的骨折类型包括肱骨远端、鹰嘴和桡骨头骨折。偶尔,这些骨折会合并出现,造成复杂损伤,如可怕的三联征损伤。使用X线和CT扫描进行准确评估对于制定最佳治疗方案至关重要。仔细的术前规划,包括决定非手术和手术治疗以及选择合适的手术植入物,对于取得成功的治疗结果至关重要。

目的

本章重点关注老年患者常见的肘部骨折,并探讨可用的治疗选择。鉴于在骨质疏松性骨肘部骨折的处理上缺乏明确的共识,我们阐述相关并发症并强调各种治疗方法。

当前认知

针对骨质疏松性肘部骨折已提出了多种治疗方法,包括各种固定技术、关节成形术和切除术。尽管有多种治疗选择,但尚无一种方法脱颖而出。每种方法都有其独特的优缺点。本章旨在汇总并比较这些选择,概述它们各自的优缺点。

结论

骨质疏松性骨的肘部骨折给外科医生带来了重大挑战。尽管与年轻个体相比,骨质疏松的老年患者通常功能需求较低,但他们在日常活动中仍需要足够的、无痛的肘部功能。手术技术和植入物技术的进步扩大了这些骨折的治疗选择。要取得成功的治疗结果,需要选择合适的植入物、进行细致的术前规划以及根据具体骨折特征进行专业的手术操作。

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