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1、创伤外科杂志2011年第13卷第3期JTraumaSurg,2011,Vo.l13,No.3223论著文章编号:1009-4237(2011)03-0223-05骨质疏松患者肱骨近端复杂骨折两种手术治疗的疗效分析潘晓华,杨述华,吴星火摘要目的探讨两种不同的手术方法治疗骨质疏松患者肱骨近端复杂骨折的临床疗效。方法2006年10月~2008年1月间,收治骨质疏松性复杂肱骨近端骨折47例,其中34例行切开复位钢板内固定术,13例行人工肱骨头置换术,记录两组术中、术后的多项相关指标及术后3~6个月的关节功能并予以统计学分析。
2、结果47例均获得随访,平均随访14.5个月;内固定组与人工肱骨头置换组相比,手术时间、切口长度、术中失血量、总输血量、术后引流量的差异均具有明显的统计学意义(P<0.05);术后两组均未发生明显并发症;术后3~6个月疗效优良率内固定组为62.5%和82.4%、人工肱骨头置换组为76.1%和84.6%;两组疗效优良率差别无明显统计学意义(P>0.05)。结论两种治疗方法都适用于骨质疏松患者肱骨近端三、四部分骨折,但人工肱骨头置换手术创伤较小。关键词肱骨骨折;骨质疏松;内固定;关节置换术中图分类号R683.41文献标识码A
3、ClinicaleffectsofoperativetreatmentsforcomplexproximalhumeralfracturesofosteoporoticpatientsPANXiaohua,YANGShuhua,WUXinghuo(DepartmentofOrthopedics,SecondMedicalCollegeofJinanUniversity,ShenzhenPeoplesHospita,lShenzhen518020,China)AbstractObjectiveToinvestigateth
4、eclinicaleffectsoftwodifferentoperativemethodsforthetreatmentofcomplexproximalhumeralfracturesofosteoporoticpatients.MethodsTotally47osteoporoticpatientswithcomplexproximalhumeralfracturesweretreatedinourhospitalduringOct.2006toJan.2008,including30casesoftypeNeerIIIand1
5、7casesoftypeNeerIV.Thirtyfourpatientsweretreatedbyopenreductionandinternalfixation(ORIFgroup),andtheother13patientsweretreatedbyshoulderhemiarthroplasty(HAPgroup).Therelativeindexesofintraoperative/postoperativesituationandclinicaleffect(ASESscore)at36monthspostoperati
6、velywereobservedandanalyzedstatistically.ResultsAllcaseswerefollowedup,averaging14.5months.Theincisionlength,operationtime,intraoperativebloodloss,totalvolumeofbloodtransfusion,postoperativedrainageoftheHAPgroupshowedstatisticaldifferencecomparingwiththeORIFgroup.Bothgro
7、upsobtainedsatisfactoryoutcomes,andtherateofexcellentandgoodat36monthspostoperativelywas82.4%,84.6%respectivelyintheHAPgroup,while76.1%,84.6%respectivelyintheORIFgroup.Theshort-termfollowupindicatednodifferencesbetweenthetwogroups(P>0.05).ConclusionBothmethodsmightcons
8、tituteareasonableandappropriatetherapeuticoptionforthetreatmentofcomplexproximalhumeralfractures
