CAJ | 학술논문

目的：探讨手术内固定治疗老年肱骨近端骨折的疗效。方法：回顾性研究分析2009年7月～2012年8月采用手术切开复位内固定治疗43例老年（大于70岁）肱骨近端有移位骨折。9例因痴呆或死亡使随访数据不完整，剩余34例获得完整随访，平均随访时间2．1年（1～4．2年）。结果：骨折复位满意率87％。所有患者均获得骨性愈合。术后6％患者出现骨坏死。术后2周固定没有导致关节僵硬。至随访结束肩关节活动范围：平均屈伸143°±38°；平均外展131°±35°；内旋平均L1±2阶段，正常侧T8±2阶段；外旋35°±26°（表1）。平均ASES为69．5。结论：手术治疗老年肱骨近端骨折，术中仔细操作，对存在粉碎性骨折的给予充分植骨，术中内侧和内后侧复位良好，并采用短螺钉固定肱骨头，可以有效避免手术并发症并获得良好的关节功能。
목적：탐토수술내고정치료노년굉골근단골절적료효。방법：회고성연구분석2009년7월～2012년8월채용수술절개복위내고정치료43례노년（대우70세）굉골근단유이위골절。9례인치태혹사망사수방수거불완정，잉여34례획득완정수방，평균수방시간2．1년（1～4．2년）。결과：골절복위만의솔87％。소유환자균획득골성유합。술후6％환자출현골배사。술후2주고정몰유도치관절강경。지수방결속견관절활동범위：평균굴신143°±38°；평균외전131°±35°；내선평균L1±2계단，정상측T8±2계단；외선35°±26°（표1）。평균ASES위69．5。결론：수술치료노년굉골근단골절，술중자세조작，대존재분쇄성골절적급여충분식골，술중내측화내후측복위량호，병채용단라정고정굉골두，가이유효피면수술병발증병획득량호적관절공능。
Objective:To discuss the effect of Surgical treatment for older patients with proximal humeral fractures .Mtehods:We retro-spectively reviewed all 43 patients older than 70 years with displaced proximal humerus fractures treated using open reduction and internal fixation technique between July 2009 and August2012.All patients were immobilized for 2weeks after surgery.Nine of the 43 patients ei-ther died or developed severe dementia during followup .The analysis included 34 patients followed an average of 2.1 years (range, 1-4. 2 years) .Results:An acceptable reduction was achieved in 87%of the shoulders and maintained over time .All fractures healed .Osteo-necrosis was noted on radiographs in 6%of the shoulders .Two weeks of immobilization did not lead to disabling stiffness .At most recent followup, mean active elevation was143°±38°, mean active external rotation 131°±35°, mean active internal rotation L1 ±2levels, mean active external rotation 35°±26°, and mean American Society of Shoulder and Elbow Surgeons score 69.5.Conclusions: With Carefully Operation , adequate bone graft , medial and posterointernal reduction , short screw , Surgical treatment for older patients with proximal humeral fractures could receive good shoulder function and avoid complications of surgery .