CAJ | 학술논문

目的观察肱骨近端锁定加压接骨板治疗老年人复杂性肱骨近端骨折的临床疗效和影响疗效的相关因素. 方法肱骨近端骨折39例,年龄60～83岁.根据Neer分型:三部分骨折29例,四部分骨折10例.经胸大肌、三角肌入路,采用肱骨近端锁定钢板固定.用N eer肩关节功能评分标准行术后患肩功能评分,并对疗效进行分析. 结果 39例患者随访平均16个月,依据Neer肩关节功能评分,三部分骨折优良率86.2％(25例),四部分骨折优良率50.0％(5例),总体优良率76.9％(30例).多因素Logistic逐步回归分析结果提示,患者年龄(OR=1.314,P＜0.05)和骨折类型是(OR=1.295,P＜0.05)影响老年肱骨近端骨折预后的独立危险因素. 结论肱骨近端锁定钢板是治疗老年人肱骨近端复杂骨折的有效方法.年龄和骨折类型是影响预后的主要因素.
목적 관찰굉골근단쇄정가압접골판치료노년인복잡성굉골근단골절적림상료효화영향료효적상관인소. 방법 굉골근단골절39례,년령60～83세.근거Neer분형:삼부분골절29례,사부분골절10례.경흉대기、삼각기입로,채용굉골근단쇄정강판고정.용N eer견관절공능평분표준행술후환견공능평분,병대료효진행분석. 결과 39례환자수방평균16개월,의거Neer견관절공능평분,삼부분골절우량솔86.2％(25례),사부분골절우량솔50.0％(5례),총체우량솔76.9％(30례).다인소Logistic축보회귀분석결과제시,환자년령(OR=1.314,P＜0.05)화골절류형시(OR=1.295,P＜0.05)영향노년굉골근단골절예후적독립위험인소. 결론 굉골근단쇄정강판시치료노년인굉골근단복잡골절적유효방법.년령화골절류형시영향예후적주요인소.
Objective To observe the clinical effects of locking proximal humerus plate(LPHP) in the treatment of complex proximal humeral fracture of aged patients and to analyze the influencing factors. Methods Among 39 cases with complex humeral fractures (aged 60-83 years),there were 29 cases with three-part fractures and 10 with four-part fractures according to the Neer classification.They were operated by LPHP via deltoid-pectoral approach. Neer numerical rating system was employed to evaluate postoperative function of shoulders. Results 39 cases were followed up for average of 16 months.According to Neer numerical rating system,the excellence rates of three-part fractures and four-part fractures were 86.2％ (25 cases) and 50.0％ (5 cases),respectively,with total excellence rate of 76.9％ (30 cases). Age (OR =1.314, P＜0.05) and fracture type ( OR =1.295, P＜0.05) of patients were independent risk factors for prognosis of proximal humeral fracture of aged patients by multiple logistic regression. Conclusions LPHP is an effective implant for treating complex proximal humeral fracture of aged patients,with age and fracture types as important risk factors of prognosis.<英文关键词>=humeral fractures