老年患者PHILOS骨融合术的功能结果:三级保健中心的经验

N. Kushwaha, Sushila Saini, Ashutosh Verma, R. Mohan, A. Saroj, Arpit Singh, M. Prajwal
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摘要

背景:由于老年人骨质疏松或脆性,肱骨近端骨折的风险增加。在老年严重骨质疏松患者中,骨折多由低速间接创伤引起,而在低龄人群中,高速创伤如道路交通事故是导致骨折的主要原因。手术是获得更好的功能结果或当复杂骨折需要固定时的一种选择。考虑到PHILOS钢板内固定治疗肱骨近端移位骨折的优势和数据的缺乏,本研究计划进行。方法:将符合选择标准的患者告知研究,然后纳入研究。手术后,患者在6周、3个月和6个月定期随访。用恒肩线评分法分析最终结果。克里斯托弗·康斯坦特(Christopher Constant)在已故的艾伦·穆雷(Alan Murley)的帮助下,于1981年至1986年设计出了“恒定分数”,并于1986年在一篇大学论文中首次提出,其方法后来于1987年发表。结果:对30例肱骨近端骨折患者进行了研究。在本研究中,采用恒肩线评分法对73.2%的患者进行最终评估,结果为良至优。结论:通过本研究,可以得出结论,肱骨近端内锁系统治疗肱骨近端骨折在大多数患者中具有良好的功能预后。因此,PHILOS钢板应用于老年患者肱骨近端骨折的固定,从而使肩部能够早期活动。
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Functional outcome of osteosynthesis with PHILOS in elderly patients: Experience at tertiary care centre
Background: Increased risk of proximal humerus fractures are seen in elderly group as their bones are osteoporotic or brittle. Mode of trauma in elderly patients with severe osteoporosis, fractures usually resulted from low velocity indirect trauma while high velocity trauma like road traffic accident was the cause of these fractures in younger age group. Surgery can be an option to obtain a better functional outcome or when a complex fracture needs to be fixed. With the advantages and the paucity of data on the functional outcome and efficacy of the following internal fixation with the PHILOS plate for displaced proximal humerus fractures in mind, the present study was planned. Methodology: Patients who fulfilled the selection criteria were informed about the study and were then enrolled. Following the surgery, patients were followed up regularly at six weeks, three months, and six months. Final outcome was analyzed by Constant Shoulder Score. Christopher Constant, with the help of the late Alan Murley during the years 1981–1986, devised the Constant Score, which was first presented in a university thesis in 1986 and whose methodology was later published in 1987. Results: A total of 30 patients sustained with proximal humerus fractures were studied. In this study of final assessment were Found 73.2 % good to excellent outcome by using the Constant Shoulder Score. Conclusion: Following this study, the inference can be drawn that proximal humerus internal locking system for the management of proximal humerus fractures give a good functional outcome in most patients. Hence PHILOS plate application for fixation of fracture proximal humerus in elderly patients hence allowing early mobilization of the shoulder.
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