高龄肱骨近端骨折治疗研究进展
摘要
<正>肱骨近端骨折指肱骨外科颈以远1～2 cm至肱骨头关节面之间,包括肱骨干近端、大结节、小结节、肱骨头四部分的骨折,常伴有肩袖、周围神经血管损伤[1]。肱骨近端骨折约占全身骨折的5%,多发于65岁以上的骨质疏松者,男女比例约为1∶2[2-3]。因老年患者骨密度低下、骨皮质变薄,在创伤下极易造成粉碎性骨折,占整个肱骨近端骨折的5%～10%,老年复杂粉碎性骨折的外科治疗一直
引文
[1] 魏均强,张伯勋,唐佩福,等.肱骨近端骨折分型和诊治进展[J].中华创伤杂志,2010,26(11):1053-1056.
[2] Uzer G,Yildiz F,Batar S,et al.Does grafting of the tuberosities improve the functional outcomes of proximal humeral fractures treated with reverse shoulder arthroplasty[J].J Shoulder Elbow Surg,2017,26(1):36-41.
[3] Helmy N,Hintermann B.New trends in the treatment of proximal humerus fractures[J].Clin Orthop Res,2006,442(442):100-108.
[4] Boons HW,Goosen JH,van Grinsven S,et al.Hemiarthroplasty for humeral four-part fractures for patients 65 years and older:a randomized controlled trial[J].Clin Orthop Relat Res,2012,470(12):3483-3491.
[5] Bonnevialle N,Ibnoulkatib A,Mansat P,et al.Kapandji pinning and tuberosities fixation of three- and four-part fractures of the proximal humerus[J].Int Orthop,2013,37(10):1965-1971.
[6] Maier D,Jaeger M,Izadpanah K,et al.Proximal humeral fracture treatment in adults[J].J Bone Joint Surg Am,2014,96(3):251-261.
[7] Codman EA.Rupture of the supraspinatus tendon[J].Clin Orthop Relat Res,1938,231(5974):3-26.
[8] Neer CS.Displaced proximal humeral fractures.I.Classification and evaluation[J].J Bone Joint Surg Am,1970,52(6):1077-1089.
[9] Papakonstantinou MK,Hart MJ,Farrugia R,et al.Interobserver agreement of Neer and AO classifications for proximal humeral fractures[J].Anz J Surg,2016,86(4):280-284.
[10] Hertel R,Hempfing A,Stiehler M,et al.Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus[J].J Shoulder Elbow Surg,2004,13(4):427-433.
[11] Murray IR,Amin AK,White TO,et al.Proximal humeral fractures:current concepts in classification,treatment and outcomes[J].J Bone Joint Surg Br,2011,93(1):1-11.
[12] Fjalestad T,Hole MO,Hovden IA,et al.Surgical treatment with an angular stable plate for complex displaced proximal humeral fractures in elderly patients:a randomized controlled trial[J].J Orthop Trauma,2012,26(2):98-106.
[13] Gallo RA,Sciulli R,Daffner RH,et al.Defining the relationship between rotator cuff injury and proximal humerus fractures[J].Clin Orthop & Res,2007,458(458):70-77.
[14] Nanidis TG,Majed A,Liddle AD,et al.Conservative versus operative management of complex proximal humeral fractures:a meta-analysis[J].Shoulder & Elbow,2010,2(3):166-174.
[15] Hanson B,Neidenbach P,de Boer P,et al.Functional outcomes after nonoperative management of fractures of the proximal humerus[J].J Shoulder Elbow Surg,2009,18(4):612-621.
[16] Lill H,Bewer A,Korner J,et al.Conservative treatment of dislocated proximal humeral fractures[J].Zentralblatt Für Chirurgie,2001,126(3):205-210.
[17] 江伦发,江峰,张明河,等.克氏针交叉结合非金属外固定架固定治疗老年肱骨近端粉碎性骨折52例[J].中国骨与关节损伤杂志,2012,27(9):843-844.
[18] 明立功,明新堂,明新月,等.闭合复位经皮外固定支架治疗移位的肱骨外科颈骨折[J].中华创伤杂志,2011,27(2):146-147.
[19] Laux CJ,Grubhofer F,Werner CML,et al.Current concepts in locking plate fixation of proximal humerus fractures[J].J Orthop Surg Res,2017,12(1):137.
[20] Pennington SD,Dural de XA.Locking plate fixation for proximal humerus fractures[J].Am J Orthop (Belle Mead NJ),2014,43(7):302-306.
[21] Tan E,Lie D,Wong MK.Early outcomes of proximal humerus fracture fixation with locking plate and intramedullary fibular strut graft[J].Orthopedics,2014,37(9):e822.
[22] Zhu L,Liu YJ,Yang ZY,et al.Locking plate fixation combined with iliac crest bone autologous graft for proximal humerus comminuted fracture[J].Chinese Med J,2014,127(9):1672-1676.
[23] Jost B,Spross C,Grehn H,et al.Locking plate fixation of fractures of the proximal humerus:analysis of complications,revision strategies and outcome[J].J Shoulder Elbow Surg,2013,22(4):542-549.
[24] Sproul RC,Iyengar JJ,Devcic Z,et al.A systematic review of locking plate fixation of proximal humerus fractures[J].Injury,2011,42(4):408-413.
[25] Maier D,Jaeger M,Izadpanah K,et al.Proximal humeral fracture treatment in adults[J].J Bone Joint Surg Am,2014,96(3):251-261.
[26] Gradl G,Dietze A,K??b M,et al.Is locking nailing of humeral head fractures superior to locking plate fixation[J].Clin Orthop Res,2009,467(11):2986-2993.
[27] Francois H,Peter B,Michae D,et al.Predictive factors for functional outcome and failure in angular stable osteosynthesis of the proximal humerus[J].Injury,2012,43(2):153-158.
[28] Dilisio MF,Nowinski RJ,Hatzidakis AM,et al.Intramedullary nailing of the proximal humerus:evolution,technique,and results[J].J Shoulder Elbow Surg,2016,25(5):e130.
[29] Gracitelli MEC,Malavolta EA,Assuncao H,et al.Ultrasound evaluation of the rotator cuff after osteosynthesis of proximal humeral fractures with locking intramedullary nail[J].Rev Bras Ortop,2017,52(5):601-607.
[30] Wang G,Mao Z,Zhang L,et al.Meta-analysis of locking plate versus intramedullary nail for treatment of proximal humeral fractures[J].J Orthop Surg Res,2015,10(1):122.
[31] Jaeger M,Maier D,Izadpanah K,et al.Limitations of reconstruction prostheses[J].Unfallchirurg,2011,114(12):1068-1074.
[32] 刘长路,刘晓民,黄健,等.半肩关节置换治疗复杂肱骨近端骨折[J].中国组织工程研究,2013,17(52):8987-8992.
[33] Postacchini R,Castagna A,Borroni M,et al.Total shoulder arthroplasty for the treatment of failed hemiarthroplasty in patients with fracture of the proximal humerus[J].J Shoulder Elbow Surg,2012,21(11):1542-1549.
[34] Bastian JD,Hertel R.Osteosynthesis and hemiarthroplasty of fractures of the proximal humerus:outcomes in a consecutive case series[J].J Shoulder Elbow Surg,2009,18(2):216-219.
[35] Robinson CM,Page RS,Hill RM,et al.Primary hemiarthroplasty for treatment of proximal humeral fractures[J].J Bone Joint Surg Am,2003,85(7):1215-1223.
[36] Cadet ER,Ahmad CS.Hemiarthroplasty for three- and four-part proximal humerus fractures[J].J Am Acad Orthop Surg,2012,20(1):17-27.
[37] Levy J,Frankle M,Mighell M,et al.The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture[J].J Bone Joint Surg Am,2007,89(2):292-300.
[38] Gigis I,Nenopoulos A,Giannekas D,et al.Reverse shoulder arthroplasty for the treatment of 3 and 4- part fractures of the humeral head in the elderly[J].Open Orthop J,2017,11:108-118.
[39] Nicholson GP,Strauss EJ,Sherman SL.Scapular notching:recognition and strategies to minimize clinical impact[J].Clin Orthop Relat Res,2011,469(9):2521-2530.
[40] Cho CH,Kim DH,Song KS.Reverse shoulder arthroplasty in patients with rheumatoid arthritis:a systematic review[J].Clin Orthop Surg,2017,9(3):325-331.
[41] Kim SH,Lee YH,Chung SW,et al.Outcomes for four-part proximal humerus fractures treated with a locking compression plate and an autologous iliac bone impaction graft[J].Injury,2012,43(10):1724-1731.
[42] Raphael JS,Booker MR,Saing MH,et al.Locked plate fixation of proximal humerus fractures using cannulated subchondral support pegs[J].Shoulder & Elbow,2013,5(3):178-182.
[2] Uzer G,Yildiz F,Batar S,et al.Does grafting of the tuberosities improve the functional outcomes of proximal humeral fractures treated with reverse shoulder arthroplasty[J].J Shoulder Elbow Surg,2017,26(1):36-41.
[3] Helmy N,Hintermann B.New trends in the treatment of proximal humerus fractures[J].Clin Orthop Res,2006,442(442):100-108.
[4] Boons HW,Goosen JH,van Grinsven S,et al.Hemiarthroplasty for humeral four-part fractures for patients 65 years and older:a randomized controlled trial[J].Clin Orthop Relat Res,2012,470(12):3483-3491.
[5] Bonnevialle N,Ibnoulkatib A,Mansat P,et al.Kapandji pinning and tuberosities fixation of three- and four-part fractures of the proximal humerus[J].Int Orthop,2013,37(10):1965-1971.
[6] Maier D,Jaeger M,Izadpanah K,et al.Proximal humeral fracture treatment in adults[J].J Bone Joint Surg Am,2014,96(3):251-261.
[7] Codman EA.Rupture of the supraspinatus tendon[J].Clin Orthop Relat Res,1938,231(5974):3-26.
[8] Neer CS.Displaced proximal humeral fractures.I.Classification and evaluation[J].J Bone Joint Surg Am,1970,52(6):1077-1089.
[9] Papakonstantinou MK,Hart MJ,Farrugia R,et al.Interobserver agreement of Neer and AO classifications for proximal humeral fractures[J].Anz J Surg,2016,86(4):280-284.
[10] Hertel R,Hempfing A,Stiehler M,et al.Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus[J].J Shoulder Elbow Surg,2004,13(4):427-433.
[11] Murray IR,Amin AK,White TO,et al.Proximal humeral fractures:current concepts in classification,treatment and outcomes[J].J Bone Joint Surg Br,2011,93(1):1-11.
[12] Fjalestad T,Hole MO,Hovden IA,et al.Surgical treatment with an angular stable plate for complex displaced proximal humeral fractures in elderly patients:a randomized controlled trial[J].J Orthop Trauma,2012,26(2):98-106.
[13] Gallo RA,Sciulli R,Daffner RH,et al.Defining the relationship between rotator cuff injury and proximal humerus fractures[J].Clin Orthop & Res,2007,458(458):70-77.
[14] Nanidis TG,Majed A,Liddle AD,et al.Conservative versus operative management of complex proximal humeral fractures:a meta-analysis[J].Shoulder & Elbow,2010,2(3):166-174.
[15] Hanson B,Neidenbach P,de Boer P,et al.Functional outcomes after nonoperative management of fractures of the proximal humerus[J].J Shoulder Elbow Surg,2009,18(4):612-621.
[16] Lill H,Bewer A,Korner J,et al.Conservative treatment of dislocated proximal humeral fractures[J].Zentralblatt Für Chirurgie,2001,126(3):205-210.
[17] 江伦发,江峰,张明河,等.克氏针交叉结合非金属外固定架固定治疗老年肱骨近端粉碎性骨折52例[J].中国骨与关节损伤杂志,2012,27(9):843-844.
[18] 明立功,明新堂,明新月,等.闭合复位经皮外固定支架治疗移位的肱骨外科颈骨折[J].中华创伤杂志,2011,27(2):146-147.
[19] Laux CJ,Grubhofer F,Werner CML,et al.Current concepts in locking plate fixation of proximal humerus fractures[J].J Orthop Surg Res,2017,12(1):137.
[20] Pennington SD,Dural de XA.Locking plate fixation for proximal humerus fractures[J].Am J Orthop (Belle Mead NJ),2014,43(7):302-306.
[21] Tan E,Lie D,Wong MK.Early outcomes of proximal humerus fracture fixation with locking plate and intramedullary fibular strut graft[J].Orthopedics,2014,37(9):e822.
[22] Zhu L,Liu YJ,Yang ZY,et al.Locking plate fixation combined with iliac crest bone autologous graft for proximal humerus comminuted fracture[J].Chinese Med J,2014,127(9):1672-1676.
[23] Jost B,Spross C,Grehn H,et al.Locking plate fixation of fractures of the proximal humerus:analysis of complications,revision strategies and outcome[J].J Shoulder Elbow Surg,2013,22(4):542-549.
[24] Sproul RC,Iyengar JJ,Devcic Z,et al.A systematic review of locking plate fixation of proximal humerus fractures[J].Injury,2011,42(4):408-413.
[25] Maier D,Jaeger M,Izadpanah K,et al.Proximal humeral fracture treatment in adults[J].J Bone Joint Surg Am,2014,96(3):251-261.
[26] Gradl G,Dietze A,K??b M,et al.Is locking nailing of humeral head fractures superior to locking plate fixation[J].Clin Orthop Res,2009,467(11):2986-2993.
[27] Francois H,Peter B,Michae D,et al.Predictive factors for functional outcome and failure in angular stable osteosynthesis of the proximal humerus[J].Injury,2012,43(2):153-158.
[28] Dilisio MF,Nowinski RJ,Hatzidakis AM,et al.Intramedullary nailing of the proximal humerus:evolution,technique,and results[J].J Shoulder Elbow Surg,2016,25(5):e130.
[29] Gracitelli MEC,Malavolta EA,Assuncao H,et al.Ultrasound evaluation of the rotator cuff after osteosynthesis of proximal humeral fractures with locking intramedullary nail[J].Rev Bras Ortop,2017,52(5):601-607.
[30] Wang G,Mao Z,Zhang L,et al.Meta-analysis of locking plate versus intramedullary nail for treatment of proximal humeral fractures[J].J Orthop Surg Res,2015,10(1):122.
[31] Jaeger M,Maier D,Izadpanah K,et al.Limitations of reconstruction prostheses[J].Unfallchirurg,2011,114(12):1068-1074.
[32] 刘长路,刘晓民,黄健,等.半肩关节置换治疗复杂肱骨近端骨折[J].中国组织工程研究,2013,17(52):8987-8992.
[33] Postacchini R,Castagna A,Borroni M,et al.Total shoulder arthroplasty for the treatment of failed hemiarthroplasty in patients with fracture of the proximal humerus[J].J Shoulder Elbow Surg,2012,21(11):1542-1549.
[34] Bastian JD,Hertel R.Osteosynthesis and hemiarthroplasty of fractures of the proximal humerus:outcomes in a consecutive case series[J].J Shoulder Elbow Surg,2009,18(2):216-219.
[35] Robinson CM,Page RS,Hill RM,et al.Primary hemiarthroplasty for treatment of proximal humeral fractures[J].J Bone Joint Surg Am,2003,85(7):1215-1223.
[36] Cadet ER,Ahmad CS.Hemiarthroplasty for three- and four-part proximal humerus fractures[J].J Am Acad Orthop Surg,2012,20(1):17-27.
[37] Levy J,Frankle M,Mighell M,et al.The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture[J].J Bone Joint Surg Am,2007,89(2):292-300.
[38] Gigis I,Nenopoulos A,Giannekas D,et al.Reverse shoulder arthroplasty for the treatment of 3 and 4- part fractures of the humeral head in the elderly[J].Open Orthop J,2017,11:108-118.
[39] Nicholson GP,Strauss EJ,Sherman SL.Scapular notching:recognition and strategies to minimize clinical impact[J].Clin Orthop Relat Res,2011,469(9):2521-2530.
[40] Cho CH,Kim DH,Song KS.Reverse shoulder arthroplasty in patients with rheumatoid arthritis:a systematic review[J].Clin Orthop Surg,2017,9(3):325-331.
[41] Kim SH,Lee YH,Chung SW,et al.Outcomes for four-part proximal humerus fractures treated with a locking compression plate and an autologous iliac bone impaction graft[J].Injury,2012,43(10):1724-1731.
[42] Raphael JS,Booker MR,Saing MH,et al.Locked plate fixation of proximal humerus fractures using cannulated subchondral support pegs[J].Shoulder & Elbow,2013,5(3):178-182.