Abstract:
Objective To investigate the effect of humerus intramedullary nailing for the treatment of elderly patients with proximal humerus fractures.
Methods A retrospective study of 60 elderly patients with proximal humeral fractures admitted to the Department of Orthopaedics, Jiaozhou People’s Hospital, Shandong Province from July 2016 to February 2018 were enrolled in this study, including 27 males and 33 females, aged 60-84(68.96±3.41)years, average fracture time (1.81±0.33) weeks. According to the random number table method, the patients were divided into control group (using locking plate method) and observation group (receiving intramedullary nail fixation). The surgical time, intraoperative blood loss, fracture healing time/shoulder joint mobility, constant score, and postoperative complications were compared between the two groups.Hemorheological parameters were detected and compared between the two groups of patients before and after treatment.
Results The operation time, intraoperative blood loss and fracture healing time of the observation group were all lower than that of the control group(P<0.05). The number of external rotations of the observation group was higher than that of the control group(P<0.05). There were no significant differences in the evaluation of other shoulder function and the constant score between the two groups(P>0.05). There was no significant difference in blood rheology between the two groups before operation(P>0.05). There were different degrees of reduction in the plasma viscosity, whole blood viscosity and fibrinogen level after treatment of the observation group were lower than those of the control group(P<0.05). In the control group, 1 case of incision infection, 4 cases of delayed fracture healing and 3 cases of venous thrombosis, the total incidence was 24%. Observation group, 1 case of incision infection, 1 case of delayed fracture healing and 1 case of venous thrombus, the total incidence was 10%.
Conclusion The humerus intramedullary nailing has a better effect on the proximal humerus fractures, and this surgical method takes less time and has less bleeding, and the postoperative hemorheology index changes are normal, which may shorten bone healing time and improve prognosis.
Key words:
Humeral fractures,
Intramedullary nail fixation,
Shoulder mobility,
Hemorheology
Shulin Zhao, Kun Han, Yuankun Zhang, Lei Wang. Effects of improved intramedullary nailing on shoulder function and hemorheology in elderly patients with humeral neck fracture[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2020, 06(01): 32-35.