CAJ | 학술논문

目的探讨长型肱骨近端锁定板经肱骨外侧入路微创固定老年骨质疏松性肱骨中上段骨折的临床疗效. 方法 2010年2月至2012年1月使用长型肱骨近端锁定板经肱骨外侧入路微创固定治疗老年骨质疏松性肱骨中上段骨折.根据AO/OTA分型:B型5例,C型8例.术中记录手术时间,出血量.采用Constant-Murley肩关节评分标准,对患者健侧、患侧肩关节进行评分,同时计算患侧评分占健侧评分的百分比. 结果手术时间(96.1±13.1)min,出血量(153.4±45.8)ml.13例伤口全部Ⅰ期愈合,全部病例均获随访,随访(10.5±3.1)个月,骨折愈合时间(11.7±1.8)周；骨折端无移位,螺钉无松动、拔出及断钉,无肱骨头坏死.末次随访时,患侧肩关节前屈上举活动度(155.7±9.7)°.患侧在末次随访时平均(81±6.0)分；患侧评分占健侧百分比(89.3±5.8)％；优良12例,满意1例,优良率为92.3％. 结论微创经皮钢板接骨术结合长型肱骨近端锁定板外侧入路治疗肱骨中上段骨折可以提供稳定的固定,损伤小,可早期功能锻炼,骨折愈合率较高,更适合于粉碎性或骨质较差的肱骨干骨折.
목적 탐토장형굉골근단쇄정판경굉골외측입로미창고정노년골질소송성굉골중상단골절적림상료효. 방법 2010년2월지2012년1월사용장형굉골근단쇄정판경굉골외측입로미창고정치료노년골질소송성굉골중상단골절.근거AO/OTA분형:B형5례,C형8례.술중기록수술시간,출혈량.채용Constant-Murley견관절평분표준,대환자건측、환측견관절진행평분,동시계산환측평분점건측평분적백분비. 결과 수술시간(96.1±13.1)min,출혈량(153.4±45.8)ml.13례상구전부Ⅰ기유합,전부병례균획수방,수방(10.5±3.1)개월,골절유합시간(11.7±1.8)주；골절단무이위,라정무송동、발출급단정,무굉골두배사.말차수방시,환측견관절전굴상거활동도(155.7±9.7)°.환측재말차수방시평균(81±6.0)분；환측평분점건측백분비(89.3±5.8)％；우량12례,만의1례,우량솔위92.3％. 결론 미창경피강판접골술결합장형굉골근단쇄정판외측입로치료굉골중상단골절가이제공은정적고정,손상소,가조기공능단련,골절유합솔교고,경괄합우분쇄성혹골질교차적굉골간골절.
Objective To evaluate the clinical effect of minimally invasive techique with the long proximal humeral locking plate on the treatment of osteoporotic middle-proximal humeral shaft fractures.Methods From February 2010 to January 2012,a total of 13 patients with osteoporotic middle-proximal humeral shaft fractures were treated with internal fixation by using the long proximal humeral locking plate.According to AO/OTA classification,5 cases were in B type and 8 cases were in C type.The operation time and bleed volume were recorded.The contralateral and ipsilateral shoulder function was assessed by Constant-Murley shoulder assessment score and percentage of ipsilateral shoulder assessment scores on contralateral shoulder assessment scores was calculated.Results The mean operative time was (96.1 ±13.1)min and bleed volume was (153.4±45.8)ml.13 patients were followed up for (10.5±3.1)months.The cut wounds in all patients were healed at the primary stage.The mean fracture healing time was (11.7±1.8) weeks.No complications such as fracture displacement,screw loose and pullout,broken nails and necrosis of the humeral head were found.At the last follow-up,the mean range of motion (ROM)in ipsilateral shoulders was (155.7 ± 9.7) ° and the average Constant-Murley scores in ipsilateral shoulders were (81 ± 6.0).The percentage of ipsilateral shoulder assessment scores on contralateral shoulder assessment scores was (89.3 ±5.8) ％.12 patients were with excellent or good shoulder function and 1 patient was with satisfactory function after treatment.The excellent and good rate was 92.3％ (12/13 cases).Conclusions Internal fixation using the long proximal humeral locking plate can provide the stable fixation with a minimal invasion and high rate of fracture repair,and has advantage in early functional exercise for the treatment of osteoporotic middle-proximal humeral shaft fractures,which is more suitable for humeral shaft comminuted or weak hone fracture.