锁定钢板与髓内钉内固定术联合早期康复治疗肱骨近端骨折老年患者的临床疗效及可行性OA北大核心CSTPCD
Clinical efficacy and feasibility of locking plate and intramedullary nail internal fixation with early rehabilitation in elderly patients with proximal humeral fractures
目的 比较锁定钢板与髓内钉内固定术联合术后早期康复治疗肱骨近端骨折老年患者的临床疗效及可行性.方法 回顾性分析25例接受切开复位锁定钢板内固定术的肱骨近端骨折老年患者(A组)和20例接受有限切开复位髓内钉内固定术的肱骨近端骨折老年患者(B组)的临床资料,比较2组患者的手术情况、住院时间、骨折愈合时间、术后并发症发生率、术后血清炎性细胞因子水平、术后疼痛评分、肩关节功能评分、生活质量评分.2组患者均进行早期系统康复治疗.结果 B组手术时间、住院时间、骨折愈合时间均短于A组(P<0.05),术中出血量低于A组(P<0.05).术后第1～3天,B组C反应蛋白、降钙素原水平均低于A组(P<0.05).术后12～48 h,B组疼痛评分低于A组(P<0.05).术后2组患者的肩关节功能评分均较术前明显增高(P<0.05),但2组比较肩关节功能评分的差异无统计学意义(P>0.05).术后2组患者的生活质量评分均较术前明显增高(P<0.05),且B组患者的生活质量评分高于A组(P<0.05).结论 锁定钢板内固定术与髓内钉内固定术联合早期康复治疗均可有效改善肱骨近端骨折老年患者的肩关节功能,但有限切开复位髓内钉内固定术可减轻手术创伤、术后疼痛和术后炎症反应,有利于加快骨折愈合,提高患者的生活质量.
Objective To compare the clinical efficacy and feasibility of locking plate and intramedullary nail internal fixation with early rehabilitation in elderly patients with proximal humeral fractures.Methods We retrospectively analyzed the clinical data of elderly patients with proximal humeral fractures,including 25 and 20 persons receiving locking plate and intramedullary nail internal fixation(groups A and B),respectively.We compared the operation situation,length of hospital stay,fracture healing time,postoperative complica-tion incidence,postoperative serum inflammatory cytokine levels,postoperative pain score,shoulder joint function score,and quality of life score between the two groups.All patients received early rehabilitation after surgery.Results The operation time,length of hospital stay,fracture healing time,and intraoperative blood loss in group B were significantly shorter than those in group A(P<0.05).The C-reactive protein and procalcitonin levels on postoperative days 1 to 3 in group B were significantly lower than those in group A(P<0.05).The pain score 12 to 48 hours after the operation in group B was significantly lower than that in group A(P<0.05).The shoulder joint function and quality of life scores after the operation were significantly higher than those before the operation in both groups(P<0.05).Conclusion Locking plate and intramedullary nail internal fixation with early rehabilitation could effectively improve shoulder joint function in elderly patients with proximal humeral fractures.
韩新祚;亓攀;晋陶然;刘克敏;刘四海
中国康复研究中心北京博爱医院骨科,北京 100068
临床医学
肱骨近端骨折锁定钢板髓内钉早期康复治疗
proximal humeral fracturelocking plateintramedullary nailearly rehabilitation
《中国医科大学学报》 2024 (006)
525-530 / 6
首都卫生发展科研专项(首发2020-2Z-6013)
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