摘要
目的探究肩前内侧入路锁定接骨板内固定(PHILOS)联合肩袖修复及前肩峰成形术对老年肱骨近段骨折合并肩袖损伤及前肩峰增生患者的有效性。方法回顾性分析2014年1月—2018年12月笔者在南京市栖霞区医院采用PHILOS联合肩袖修复术治疗的80例老年肱骨近端骨折患者资料,男性13例,女性67例;年龄62~82岁,平均69.2岁。根据手术方法将其分为研究组(n=24例)与对照组(n=56)。研究组行肩前内侧入路PHILOS、肩袖修复术及前肩峰成形术,对照组仅行PHILOS联合肩袖修复术。比较两组患者治疗后肩关节功能优良率及术前、术后1周、1个月、3个月的VAS评分和患者治疗满意度。结果研究组患者治疗后优良率(87.5%)高于对照组(66.0%,P<0.05);研究组患者在术后1周,1个月、3个月的VAS评分(1.6±0.7)、(1.2±0.5)、(0.9±0.8)分明显低于对照组(2.7±1.6)、(2.2±1.6)、(1.9±1.6)分,P<0.05;研究组治疗满意率(95.8%)明显优于对照组(80.3%,P<0.05)。结论PHILOS联合肩袖修复及前肩峰成形术治疗老年肱骨近段骨折合并肩袖损伤及前肩峰增生患者,临床治疗效果较好,值得临床应用及进一步研究。
Objective To explore the effectiveness of lateral shoulder approach locking plate internal fixation(PHILOS)combined with rotator cuff repair and anterior acromioplasty in elderly patients with proximal humeral fracture complicated with rotator cuff injury and anterior acromion hyperplasia.Methods Retrospective analysis of 80 elderly patients with proximal humerus fracture who underwent PHILOS combined with rotator cuff repair in Nanjing Qixia District hospital from Jan.2014 to Dec.2018 was carried out.There were 13 males and 67 females,with an average age of 69.2 years(62-82 years).According to the operative method,they were divided into two groups:24 patients in the study group and 56 patients in the control group.The study group was treated with lateral shoulder approach PHILOS,rotator cuff repair and anterior acromioplasty,while the control group was treated with PHILOS combined with rotator cuff repair.The excellent and good rate of shoulder joint function after treatment,VAS score before operation,at 1 week,at 1 month and 3 months after operation,and patients'satisfaction with treatment were compared between the two groups.Results After treatment,the excellent and good rate of the study group was higher than that of the control group(87.5%vs.66.0%,P<0.05);the VAS scores at 1 week,1 month and 3 months after operation in the study group was significantly lower than those of the control group[(1.6±0.7)vs.(2.7±1.6),(1.2±0.5)vs.(2.2±1.6),(0.9±0.8)vs.(1.9±1.6),P<0.05)];the satisfaction rate of the study group was significantly better than that of the control group(95.8%vs.80.3%,P<0.05).Conclusion The clinical therapeutic effect of PHILOS combined with rotator cuff repair and anterior acromioplasty in elderly patients with proximal humeral fracture complicated with rotator cuff injury and anterior acromion hyperplasia is very good.It is worthy of clinical application and further study.
作者
郑国庆
李翔
ZHENG Guo-qing;LI Xiang(Department of Orthopaedics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《创伤外科杂志》
2020年第6期424-428,共5页
Journal of Traumatic Surgery
关键词
肱骨骨折
肩袖损伤
修复术
成形术
老年
humeral fracture
rotator cuff injury
repair
acromioplasty
elderly
