中华老年骨科与康复电子杂志
中華老年骨科與康複電子雜誌
중화노년골과여강복전자잡지
Chinese Journal of Geriatric Orthopaedics and Rehbilitation (Electronic Edition)
2015年
1期
22-27
,共6页
赵晨%商培洋%车凌宾%叶庭均%庄澄宇%王蕾
趙晨%商培洋%車凌賓%葉庭均%莊澄宇%王蕾
조신%상배양%차릉빈%협정균%장징우%왕뢰
骨折固定术,内%肱骨骨折%老年人%肩袖
骨摺固定術,內%肱骨骨摺%老年人%肩袖
골절고정술,내%굉골골절%노년인%견수
Fracture fixation,internal%Humeral fractures%Aged%Rotator cuff
目的：探讨、分析锁定钢板治疗老年肱骨近端骨折合并肩袖撕裂的临床效果。方法回顾性分析2012年1月至2013年3月采用锁定钢板治疗的老年肱骨近端骨折合并肩袖撕裂患者22例，男8例，女14例，年龄61～76岁，平均（66.7±4.3）岁。术中复位骨折块后采用锁定钢板进行固定，同时使用缝线缝合修复撕裂的肩袖组织。分别在术前、末次随访时对患者进行臂、肩、手功能障碍（disabilities of the arm，shoulder and hand，DASH）上肢功能评分，并在末次随访时采用Neer肩关节功能评分标准进行临床疗效的评估。结果22例患者均获得成功随访，随访时间为25～32个月，平均（28.3±1.8）个月。末次随访时，患者平均DASH评分由术前的（132.4±5.7）分改善至（46.4±3.8）分，差异具有统计学意义（t=78.368，P＜0.05）；Neer百分制评分结果，优10例、良9例、可3例、差0例，优良率达86.4%（19/22）。所有患者均未发现术中和术后并发症。结论锁定钢板治疗老年肱骨近端骨折合并肩袖撕裂可获得较满意的临床疗效，具有术后并发症少、肩关节功能效果恢复好等优点。
目的：探討、分析鎖定鋼闆治療老年肱骨近耑骨摺閤併肩袖撕裂的臨床效果。方法迴顧性分析2012年1月至2013年3月採用鎖定鋼闆治療的老年肱骨近耑骨摺閤併肩袖撕裂患者22例，男8例，女14例，年齡61～76歲，平均（66.7±4.3）歲。術中複位骨摺塊後採用鎖定鋼闆進行固定，同時使用縫線縫閤脩複撕裂的肩袖組織。分彆在術前、末次隨訪時對患者進行臂、肩、手功能障礙（disabilities of the arm，shoulder and hand，DASH）上肢功能評分，併在末次隨訪時採用Neer肩關節功能評分標準進行臨床療效的評估。結果22例患者均穫得成功隨訪，隨訪時間為25～32箇月，平均（28.3±1.8）箇月。末次隨訪時，患者平均DASH評分由術前的（132.4±5.7）分改善至（46.4±3.8）分，差異具有統計學意義（t=78.368，P＜0.05）；Neer百分製評分結果，優10例、良9例、可3例、差0例，優良率達86.4%（19/22）。所有患者均未髮現術中和術後併髮癥。結論鎖定鋼闆治療老年肱骨近耑骨摺閤併肩袖撕裂可穫得較滿意的臨床療效，具有術後併髮癥少、肩關節功能效果恢複好等優點。
목적：탐토、분석쇄정강판치료노년굉골근단골절합병견수시렬적림상효과。방법회고성분석2012년1월지2013년3월채용쇄정강판치료적노년굉골근단골절합병견수시렬환자22례，남8례，녀14례，년령61～76세，평균（66.7±4.3）세。술중복위골절괴후채용쇄정강판진행고정，동시사용봉선봉합수복시렬적견수조직。분별재술전、말차수방시대환자진행비、견、수공능장애（disabilities of the arm，shoulder and hand，DASH）상지공능평분，병재말차수방시채용Neer견관절공능평분표준진행림상료효적평고。결과22례환자균획득성공수방，수방시간위25～32개월，평균（28.3±1.8）개월。말차수방시，환자평균DASH평분유술전적（132.4±5.7）분개선지（46.4±3.8）분，차이구유통계학의의（t=78.368，P＜0.05）；Neer백분제평분결과，우10례、량9례、가3례、차0례，우량솔체86.4%（19/22）。소유환자균미발현술중화술후병발증。결론쇄정강판치료노년굉골근단골절합병견수시렬가획득교만의적림상료효，구유술후병발증소、견관절공능효과회복호등우점。
Objective To explore and analyze the clinical outcome of locking plate in treatment of elderly proximal humerus fractures with rotator cuff tears. Methods A retrospective study was performed in 22 cases of elderly proximal humerus fractures with rotator cuff tears who undergone locking plate from January 2012 to March 2013. There were 8 males and 28 females, The average age was (66.7±4.8) years (range, 61-76 years). Surgical procedure included locking plate fixation after fracture reduction, and simultaneous rotator cuff tears were repaired through suture. Clinical effectiveness was evaluated by disabilities of the arm, shoulder and hand (DASH) before operation and at the last follow-up. Neer score was used as a indication of the function of shoulder at the last follow-up. Results All the 22 patients received an average of (28.3±1.8) months (range, 25-32 months) of follow-up. In the last follow-up visit, the DASH score decreased to (46.4±3.8) from preoperative (132.4±5.7) with statistical significance (t=78.368, P<0.05). According to Neer score, 10 cases were excellent, 9 good, and 3 fair, with the excellent rate of 86.4%(19/22). No patients had complications. Conclusion Locking plate in treatment of elderly proximal humerus fractures combined with rotator cuff tears can achieve excellent functional outcome with minimal postoperative complications.
