老年骨质疏松性肱骨近端骨折患者两种治疗方法的效果比较(1)
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[摘要] 目的 探讨经皮闭合复位微创固定治疗骨质疏松性肱骨近端骨折的老年患者的临床疗效。 方法 回顾性分析在我院接受经皮闭合复位微创固定(A组，40例)或切开复位固定(B组，46例)治疗的老年肱骨近端骨折患者的临床资料，比较两组手术时间、术后住院时间、术后并发症发生率、Constant评分情况。 结果 两组患者手术时间(t = 26.463，P = 0)、住院时间(t = 2.651，P = 0.029)、术后并发症发生情况(χ2 = 8.227，P = 0.004)比较，差异均有统计学意义，A组手术时间和住院时间均短于B组，术后并发症发生率也低于B组；Constant评分情况两组比较，差异无统计学意义(χ2 = 1.792，P = 0.181)。 结论 经皮闭合复位微创固定疗法，在保证临床疗效的同时，提高了整个治疗过程中患者的安全性，对合并骨质疏松的老年肱骨近端骨折患者具有较高的临床应用价值。
[关键词] 骨质疏松；肱骨近端骨折；经皮闭合复位微创固定
[中图分类号] R683.41 [文献标识码] A [文章编号] 1673-7210(2012)02(b)-0049-02
Comparison of two approaches in treatment of the elder patients with osteoporotic fractures of the proximal humerus
ZHU Jianguo HUANG Yongbiao
Department of Surgery, North Branch of Fujian Provincial Hospital Fujian Geriatric Hospital, Fujian Province, Fuzhou 350003, China
[Abstract] Objective To explore the clinical effect of closed reduction and percutaneous pinning internal fixation in treatment of the elder patients with osteoporotic fractures of the proximal humerus. Methods The data of the patients on closed reduction and percutaneous pinning internal fixation (group A, 40 patients) and open fixation (group B, 46 patients) in our hospital were analyzed. The time of operation and hospitalization, incidence of complication after surgery and Constant score were compared between two groups. Results The time of operation (t = 26.463, P = 0) and hospitalization (t = 2.651, P = 0.029), incidence of complication after surgery (χ2 = 8.227, P = 0.004) in group A were significantly better than those in group B. The Constant score did not show significanct difference between two groups (χ2 = 1.792, P = 0.181). Conclusion The percutaneous pinning internal fixation approach ensures the clinical effect as well as safety in the process of treatment. It is appropriate to implement the method in treatment of the elder patients with osteoporotic fractures of the proximal humerus.
[Key words] Osteoporosis; Proximal humerus fractures; Closed reduction and percutaneous fixation of minimally invasive
在60岁以上的老年人群中，由于骨质量下降很容易发生骨质疏松性骨折。当骨折发生在肱骨近端时常为复杂不稳定骨折，其发生比例占全身骨折的4%～5%[1]。因患者年龄较高在治疗过程中除了要考虑患者功能恢复情况外，还必须顾及到手术对患者的安全性造成的影响[2]。因此，造成损伤相对较小的经皮闭合复位微创固定手术对于高龄患者具有较高的临床价值。本研究将经皮闭合复位微创固定与传统手术切开复位固定治疗骨质疏松性肱骨近端骨折的疗效进行了比较 ......
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