CAJ | 학술논문

目的：肱骨近端骨折是老年患者最常见的上臂骨质疏松性骨折，属肩关节骨折，其治疗效果直接影响肩关节的生理功能。文中探讨肱骨近端锁定接骨板（ locking proximal humerus plate ， LPHP）结合抗骨质疏松药物治疗老年骨质疏松性肱骨近端粉碎性骨折的疗效。方法收集2009年4月至2012年3月间在新疆医科大学第一附属医院骨科接受手术治疗且具有完整随访资料的47例老年骨质疏松性肱骨近端粉碎性骨折患者。根据是否使用抗骨质疏松药物分为2组，即LPHP治疗组23例，其中3部分骨折13例、4部分骨折10例；LPHP＋抗骨质疏松药物治疗组（联合组）24例，其中3部分骨折13例、4部分骨折11例。结果47例患者获得随访14～38（平均23．6）个月。联合组骨折愈合时间[（96．57±2．59）d]低于LPHP治疗组[（115．91±2．73）d]；优良率（91．7％）高于LPHP治疗组（78．3％），差异均有统计学意义（P＜0．05）。结论与单纯LPHP治疗相比，结合抗骨质疏松药物治疗老年骨质疏松性肱骨近端粉碎性骨折具有固定可靠、骨折愈合时间短、优良率高等优点，加上适时积极的康复锻炼是目前治疗该类骨折较为适用的方法。
목적：굉골근단골절시노년환자최상견적상비골질소송성골절，속견관절골절，기치료효과직접영향견관절적생리공능。문중탐토굉골근단쇄정접골판（ locking proximal humerus plate ， LPHP）결합항골질소송약물치료노년골질소송성굉골근단분쇄성골절적료효。방법수집2009년4월지2012년3월간재신강의과대학제일부속의원골과접수수술치료차구유완정수방자료적47례노년골질소송성굉골근단분쇄성골절환자。근거시부사용항골질소송약물분위2조，즉LPHP치료조23례，기중3부분골절13례、4부분골절10례；LPHP＋항골질소송약물치료조（연합조）24례，기중3부분골절13례、4부분골절11례。결과47례환자획득수방14～38（평균23．6）개월。연합조골절유합시간[（96．57±2．59）d]저우LPHP치료조[（115．91±2．73）d]；우량솔（91．7％）고우LPHP치료조（78．3％），차이균유통계학의의（P＜0．05）。결론여단순LPHP치료상비，결합항골질소송약물치료노년골질소송성굉골근단분쇄성골절구유고정가고、골절유합시간단、우량솔고등우점，가상괄시적겁적강복단련시목전치료해류골절교위괄용적방법。
Objective Proximal humerus fracture is the most common upper-arm osteoporotic fracture in elderly patients and the result of treatment directly affects the physiological function of the shoulder .This article discusses the clinical effect of the locking proximal humeral plate ( LPHP) combined with anti-osteoporosis drugs in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients . Methods This study included of 47 elderly osteoporotic patients with comminuted proximal humerus fractures treated from April 2009 to March 2012 and with complete follow-up data.According to the Neer classification , the patients were divided into groups A (LPHP treatment, n=23, including 13 cases of three-part fractures and 10 cases of four-part fractures) and B (LPHP+anti-osteoporosis drugs, n=24, including 13 cases of three-part fractures and 11 cases of four-part fractures). Results All the patients were followed up for 14 to 38 (mean 23.6) months.The postoperative healing time was significantly shorter in group B than in group A ([96.57 ±2.59]d vs [115.91 ±2.73]d, P<0.05), and the excellence rate was remarkably higher in B than in A (91.7%vs 78.3%,P<0.05). Conclusion With the advantages of short healing time and high excellence rate , LPHP+anti-os-teoporosis drugs is superior to simple LPHP in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients.