[1]邢金明.切开复位锁定钢板内固定术和人工半肩关节置换术 治疗老年肱骨近端复杂骨折的对比研究[J].中医正骨,2015,27(08):11-14.
　XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):11-14.
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切开复位锁定钢板内固定术和人工半肩关节置换术 治疗老年肱骨近端复杂骨折的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年08期
页码:
11-14
栏目:
临床研究
出版日期:
2015-08-30

文章信息/Info

Title:
A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients
作者:
邢金明
浙江省杭州市桐庐县中医院,浙江 杭州 311500
Author(s):
XING Jinming
Traditional Chinese Medical Hospital of Tonglu county,Hangzhou 311500,Zhejiang,China
关键词:
肩骨折;  肱骨骨折;  骨折固定术; 内;  骨板;  关节成形术; 置换;  治疗; 临床研究性
Keywords:
shoulder fractures;  humeral fractures;  fracture fixation; internal;  bone plates;  arthroplasty; replacement;  therapies; investigational
摘要:
目的:比较切开复位锁定钢板内固定术和人工半肩关节置换术治疗老年肱骨近端复杂骨折的临床疗效和安全性。方法:回顾性分析2011年2月至2013年11月收治的47例老年肱骨近端复杂骨折患者的病例资料,30例采用切开复位锁定钢板内固定术治疗(锁定钢板组),其余17例采用人工半肩关节置换术治疗(关节置换组)。比较2组患者的手术时间、术中出血量、Constant-Murley评分及并发症发生率。结果:2组患者手术时间、术中出血量及Constant-Murley评分比较,组间差异均无统计学意义[(93.5±10.2)min,(89.2±8.4)min,t=1.476,P=0.147;(267.3±20.6)mL,(261.9±18.4)mL,t=1.023,P=0.312;(63.4±4.2)分,(65.2±3.6)分,t=-0.558,P=0.560]。47例患者均获随访,随访时间12～18个月,中位数15个月。术后锁定钢板组5例发生内固定松动或断裂、1例发生肱骨头坏死,至随访结束时关节置换组未发生相关并发症; 2组并发症发生率比较,差异无统计学意义(P=0.074)。结论:切开复位锁定钢板内固定术和人工半肩关节置换术均为治疗老年肱骨近端复杂骨折的有效术式,二者的临床疗效和安全性相当。
Abstract:
Objective:To compare the clinical curative effects and safety of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients.Methods:The medical records of 47 old patients with complicated proximal humeral fractures from February 2011 to November 2013 were analyzed retrospectively.Thirty patients(locking plate group)were treated with open reduction and locking plate internal fixation,while the others(hemiarthroplasty group)were treated with artificial shoulder hemiarthroplasty.Then the two groups were compared with each other in operative time,intraoperative blood loss,Constant-Murley scores and complication rates.Results:There was no statistical difference in the operative time,intraoperative blood loss and Constant-Murley scores between the 2 groups(93.5+/-10.2 vs 89.2+/-8.4 min,t=1.476,P=0.147; 267.3+/-20.6 vs 261.9+/-18.4 mL,t=1.023,P=0.312; 63.4+/-4.2 vs 65.2+/-3.6 points,t=-0.558,P=0.560).All patients in the 2 groups were followed up for 12-18 months with a median of 15 months.Loosening or fragmentation of the internal fixators(5 cases)and humeral head necrosis(1 case)were found in the locking plate group after the surgery,while no related complications were found in hemiarthroplasty group during the follow-up period.There was no statistical difference in the complication rate between the 2 groups(P=0.074).Conclusion:Open reduction and locking plate internal fixation is similar to artificial shoulder hemiarthroplasty in the curative effect and safety,and both of them are effective method for treatment of complicated proximal humeral fractures in old patients.

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备注/Memo

备注/Memo:
2015-05-18收稿 2015-06-11修回
更新日期/Last Update: 2015-08-30