Damanakis K, Schaal O, Mann J, Müller K H
Klinik für Unfall- und Wiederherstellungschirurgie, Klinikum der Universität Witten/Herdecke, Heinrich-Heine-Universität Düsseldorf.
Unfallchirurg. 1996 Aug;99(8):561-8.
Between 1990 and 1994, 94 patients over 65 years with subcapital humerus fractures were treated by plate osteosynthesis. All patients were operated on within 48 h after trauma. Intensive physical exercising was begun in the early postoperative period. Three months after the operation all osteosynthesis materials were removed with differentiated treatment of the subacromial area. If deemed necessary on the basis of the intraoperative findings (i.e. symptoms of impingement) treatment included a Neer acromioplasty. Sixty-nine of the 94 patients were followed up, including clinical, radiological and ultrasonographic examinations. Twenty-two patients showed an excellent, 26 a good, 9 a satisfactory and 12 an unsatisfactory result, i.e. in more than 82% of patients functional result was excellent to satisfactory. Therefore, we recommended plate osteosynthesis of subcapital humerus fractures in the elderly, in combination with our standard postoperative regimen.
1990年至1994年间，94例65岁以上的肱骨近端骨折患者接受了钢板内固定治疗。所有患者均在创伤后48小时内接受手术。术后早期即开始强化体育锻炼。术后三个月取出所有内固定材料，并对肩峰下区域进行差异化治疗。根据术中发现（即撞击症状），如有必要，治疗包括Neer肩峰成形术。对94例患者中的69例进行了随访，包括临床、放射学和超声检查。22例患者结果为优，26例为良，9例为可，12例为差，即超过82%的患者功能结果为优或可。因此，我们推荐对老年肱骨近端骨折患者采用钢板内固定，并结合我们的标准术后方案。
