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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
梁永辉,李永军,顾锋,李新天,郭文杰,刘申,梁勃冉,唐政杰,何宜蓁,韦兴.锁定钢板结合微创钢板接骨技术和髓内钉固定治疗老年肱骨近端骨折的疗效比较[J].中华老年多器官疾病杂志,2020,19(7):499~503
锁定钢板结合微创钢板接骨技术和髓内钉固定治疗老年肱骨近端骨折的疗效比较
Clinical efficacy of locking plate combined with minimally invasive plate osteosynthesis versus intramedullary nail fixation in treatment of proximal humeral fracture in the elderly
投稿时间:2020-03-21  
DOI:10.11915/j.issn.1671-5403.2020.07.118
中文关键词:  老年人;外科手术,微创性;肱骨骨折,近端
英文关键词:aged; surgical procedures, minimal invasion; humeral fractures, proximal Corresponding author:WEI Xing, E-mail:china2018ma@126.com〖FL
基金项目:
作者单位E-mail
梁永辉 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
李永军 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
顾锋 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
李新天 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
郭文杰 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
刘申 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
梁勃冉 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
唐政杰 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
何宜蓁 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
韦兴 航天中心医院骨科,北京 100049 china2018ma@126.comclinical 
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中文摘要:
      目的 对比锁定钢板结合微创钢板接骨技术(MIPO)和髓内钉固定治疗老年肱骨近端骨折的疗效。方法 回顾性分析2018年1月至2019年1月期间在航天中心医院骨科手术治疗的老年移位肱骨近端骨折患者51例的临床资料。依据治疗方法分为2组:MIPO组(n=29)和髓内钉组(n=22)。对比2组患者围术期指标、术后12h切口的视觉模拟量表(VAS)评分、并发症发生情况。分别于术后3、6、12个月,采用Constant-Murley评分对2组患者肩关节功能恢复情况进行评价。采用SPSS 13.0软件进行统计分析。2组间比较采用t检验或χ2检验。结果 MIPO组和髓内钉组患者的手术切口长度均较小[(7.3±2.7)和(7.3±2.6)cm]、术中出血量较少[(79.7±25.7)和(78.3±21.4)ml]、手术耗时较短[(64.1±17.2)和(62.5±14.6)min]、术后12h切口VAS评分较低[(2.47±0.81)和(2.44±0.69)分],2组各指标比较差异均无统计学意义(P>0.05),且术后3、6、12个月2组患者的Constant-Murley评分差异亦无统计学意义(P>0.05)。但MIPO组患者术后并发症的发生率显著高于髓内钉组[17.24%(5/29)和9.09%(2/22),P<0.05]。结论 锁定钢板结合MIPO技术和髓内钉固定治疗老年肱骨近端骨折都能获得较好疗效,髓内钉固定在控制并发症发生方面比锁定钢板结合MIPO技术更具优势。
英文摘要:
      Objective To compare the effectiveness of locking plate combined with minimally invasive plate osteosynthesis (MIPO) and intramedullary nailing in the treatment of proximal humeral fractures in the elderly. Methods The clinical data of 51 elderly patients with displaced proximal humeral fracture treated in our department from January 2018 to January 2019 were collected and analyzed retrospectively. According to the treatment, they were divided into MIPO group (n=29) and intramedullary nailing group (n=22). The perioperative indexes, visual analogue scale (VAS) score at 12 h postoperatively and incidence of complications were compared between the two groups. Constant-Murley scale was performed at 3,6 and 12 months after operation to evaluate the function of shoulder joint. SPSS statistics 13.0 was used for statistical analysis. Student′s t test or Chi-square test was employed for data com-parison between the two groups. Results The two groups both had smaller incision length [(7.3±2.7) vs (7.3±2.6)cm], less amount of intraoperative bleeding [(79.7±25.7) vs (78.3±21.4)ml], shorter operation time [(64.1±17.2) vs (62.5±14.6)min], and lower VAS score at 12h post-operatively [(2.47±0.81) vs (2.44±0.69)], and there was no significant differences between the two groups (P>0.05). No statistical difference was seen in Constant-Murley score between the two groups at 3,6 and 12 months after operation (P>0.05). However, the incidence of postoperative complications was significantly higher in the MIPO group than the intramedullary nailing group [17.24%(5/29) vs 9.09%(2/22), P<0.05]. Conclusion Both locking plate combined with MIPO technology and intramedullary nail fixation can achieve better effectiveness in the treatment of proximal humeral fractures in the elderly. The latter procedure is superior to the former one in the control of complications.
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