CAJ | 학술논문

目的：探索影响老年肱骨近端骨折功能恢复的影响因素。方法回顾分析2012年9月至2014年3月，我院治疗的老年肱骨近端骨折82例，统计分析患者的年龄、性别、手术方式、骨折分型、致伤因素、功能锻炼、围手术期并发症等各项指标，以主观性较强的DASH评分和客观性较强的Constant 肩关节评分系统为标准，行单因素分析，以了解影响老年肱骨近端骨折功能恢复的影响因素。结果根据DASH评分和Constant-Murley 评分标准，82例患者中，优66例，良11例，中4例，差3例，优良率高达93.90%。男性和女性患者、锁定钢板治疗和传统内固定治疗相比，均无显著性差异（P>0.05）；NeerⅠ、Ⅱ型患者的预后明显优于NeerⅢ、Ⅳ型患者（P<0.05）；非高能量损伤患者预后明显优于高能量损伤患者（P<0.05）；按时康复训练患者预后明显优于无康复训练患者（P<0.05）；无围术期并发症患者预后明显优于有围术期并发症患者（P<0.05）。结论骨折分型、致伤因素、功能锻炼、围手术期并发症是影响老年肱骨近端骨折功能恢复的主要因素，而性别、手术方式对老年人肱骨近端骨折功能恢复影响较小。
목적：탐색영향노년굉골근단골절공능회복적영향인소。방법회고분석2012년9월지2014년3월，아원치료적노년굉골근단골절82례，통계분석환자적년령、성별、수술방식、골절분형、치상인소、공능단련、위수술기병발증등각항지표，이주관성교강적DASH평분화객관성교강적Constant 견관절평분계통위표준，행단인소분석，이료해영향노년굉골근단골절공능회복적영향인소。결과근거DASH평분화Constant-Murley 평분표준，82례환자중，우66례，량11례，중4례，차3례，우량솔고체93.90%。남성화녀성환자、쇄정강판치료화전통내고정치료상비，균무현저성차이（P>0.05）；NeerⅠ、Ⅱ형환자적예후명현우우NeerⅢ、Ⅳ형환자（P<0.05）；비고능량손상환자예후명현우우고능량손상환자（P<0.05）；안시강복훈련환자예후명현우우무강복훈련환자（P<0.05）；무위술기병발증환자예후명현우우유위술기병발증환자（P<0.05）。결론골절분형、치상인소、공능단련、위수술기병발증시영향노년굉골근단골절공능회복적주요인소，이성별、수술방식대노년인굉골근단골절공능회복영향교소。
Objective To explore the impact factors of functional recovery of proximal humerus fractures in elderly people. Methods From September 2012 to March 2014, 82 elderly patients with proximal humeral fractures treated in our hospital were retrospectively analyzed. The patient's age, sex, surgical approach, fracture type, injury factors, functional exercise and perioperative complications were recorded. DASH score and Constant shoulder scoring system were set up as the standards. Univariate analysis were used to explore the impact factors of functional recovery of proximal humerus fractures in elderly people. Results According to the DASH score and the Constant-Murley score, excellent results were showed in 66 cases, good in 11 cases, fair in 4 cases, poor in 3 cases, and the excellent and good rate was 93.90%. There were no significant differences between male and female patients, and also between the locking plate fixation group and traditional internal fixation group, P>0.05; The prognosis of patients in Neer Ⅰ, Ⅱ type group, non-high-energy injury group, timely rehabilitation group and no perioperative complication group were significantly better than patients in Neer Ⅲ,Ⅳtype group, high-energy injury group, no rehabilitation group and perioperative complication group respectively (P<0.05). Conclusion Fracture type, injury factors, functional training, perioperative complications are the main factors affecting the functional recovery of proximal humerus fractures in elderly patients, while gender and surgical approach have less influence.