摘要
Abstract
Objective To investigate the short term effect of hemiarthroplasty and locking plate internal fixation in treatment of comminuted fracture of proximal humerus in the elderly. Methods 74 cases of patients ( aged≥75 years) with proximal humerus comminuted fracture underwent elective surgery were divided into the humeral head re-placement group (group A,n=39) and plate internal fixation group (group B, n=35). Patents in group A under-went hemiarthroplasty surgery,while in group B underwent open reduction and locking plate internal fixation. The op-eration situations of the two groups were recorded. The postoperative complications and the rehabilitation of the two groups were compared. The shoulder joint function recovery was assessed by using Constant-Murley shoulder score sys-tem. Results Operation time:group A was (88. 9 ± 8. 1) min,shorter than group B (105. 7 ± 11. 2) min (P<0. 001). Hospital stay:group A was (10. 4 ± 1. 3) d,shorter than group B (14. 3 ± 1. 8) d (P<0. 001). The bleed-ing:group A was (186. 5 ± 29. 6) ml, less than group B (237. 2 ± 50. 3) ml (P<0. 001). The postoperative drain-age:group A was (59. 7 ± 6. 1) ml, less than group B (81. 3 ± 8. 2) ml, (P<0. 001). All patients were followed up for 26~35 (30. 3 ± 3. 5) months. Postoperative shoulder adduction angle: group A was 43°(41° ~49°), more than group B 29°(27°~33°);abduction angle:group A was 81°(78°~84°), more than group B 70°(68°~73°);internal rotation angle:group A was 30°(28° ~34°), more than B group 22°(19° ~24°);external rotation angle:group A was 34°(31°~37°), more than group B 18°(16°~22°);the differences were statistically significant (P<0. 001). Constant-Murley score:group A was (79. 4 ± 2. 7) points, higher than group B (67. 3 ± 3. 1) points (P<0. 001). Clinical recovery time:group A was (9. 7 ±1. 9) weeks, shorter than group B (15. 4 ±4. 1) weeks (P<0. 001). Incidence of postoperative complications:group A was 12. 8%, lower than group B 25. 7%,but there were no significant differences in the two groups (P>0. 05). Conclusions The hemiarthroplasty in treatment of aged≥75 years patients has the advantages of shorter operative time, less blood loss, faster recovery of shoulder function, fewer complications, etc. The short term effects are exact.关键词
肱骨近端骨折/肱骨头置换术/锁定钢板内固定Key words
proximal humerus fractures/hemiarthroplasty replacement/locking plate internal fixation分类
医药卫生
