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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Proximal fractures of the humerus in patients older than 75?years of age: should we consider operative treatment?
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Proximal fractures of the humerus in patients older than 75?years of age: should we consider operative treatment?

机译：75岁以上患者的肱骨近端骨折：我们应考虑手术治疗吗？

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class="Heading">Background class="Para">Over 75?% of patients presenting with a proximal humerus fracture are 70?years or older. Very little is known about the outcome after operative treatment of these fractures in very old patients. This study was performed to gain more insight in safety and functional outcome of surgical treatment of proximal humerus fractures in the elderly. class="Heading">Materials and methods class="Para">In this observational study, we analyzed all operatively treated patients, aged 75 or older, with a proximal humerus fracture between January 2003 and December 2008 in our center. Patient selection was on clinical grounds, based on physical, mental, and social criteria. Complications were evaluated. We used the DASH Questionnaire to investigate functional outcome, pain, and ADL limitations. class="Heading">Results class="Para">Sixty-four patients were treated surgically for a displaced proximal fracture of the humerus: 15 two-part, 32 three-part, and 17 four-part fractures. Mean DASH scores were 37.5, 36.9, and 48.6, respectively. Regarding the operative methods, overall good results were obtained with the modern locked plate osteosynthesis (mean DASH 34.4). Prosthetic treatment, mostly used in highly comminuted fractures, often resulted in poor function (mean DASH 72.9). Persistent pain and ADL limitations were more present in more comminuted fractures (64 and 50?% in patients with 4-part fractures vs. 14?% in 2-part fractures). There were no postoperative deaths within 3?months of surgery, and fracture-related and non-fracture-related complication rates were low (non-union 3?%; 1 myocardial infarction). class="Heading">Conclusion class="Para">This study shows that it is safe and justifiable to consider surgical treatment of a severely dislocated proximal humerus fracture in selected patients aged 75 and older. class="Heading">Level of evidence class="Para">According to OCEBM Working Group, Level IV.
机译：class =“ Heading”>背景 class =“ Para”>出现肱骨近端骨折的患者中，超过75％的患者年龄为70岁或以上。对于非常老的患者，对这些骨折进行手术治疗后的结果知之甚少。进行这项研究的目的是在老年人的肱骨近端骨折手术治疗的安全性和功能结局方面获得更多见识。 class =“ Heading”>材料和方法 class =“ Para” >在这项观察性研究中，我们分析了我中心2003年1月至2008年12月之间所有接受手术治疗的75岁以上老年患者的肱骨近端骨折的情况。根据身体，精神和社会标准，根据临床理由选择患者。评估并发症。我们使用DASH问卷调查了功能结局，疼痛和ADL局限性。 class =“ Heading”>结果 class =“ Para”>对64例患者进行了手术治疗肱骨近端移位的骨折：15例分为两部分，32例为三部分，17例为四部分。 DASH平均得分分别为37.5、36.9和48.6。关于手术方法，现代锁钢板固定术获得了总体良好的效果（平均DASH 34.4）。假肢治疗通常用于高度粉碎性骨折，通常导致功能不佳（平均DASH 72.9）。持续性疼痛和ADL限制在粉碎性更强的骨折中更为常见（四部分骨折患者为64％和50％，而两部分骨折患者为14％）。手术后3个月内无术后死亡，骨折相关和非骨折相关并发症发生率低（不愈合3％，心肌梗死1例）。 class =“ Heading” >结论 class =“ Para”>这项研究表明，对于75岁及以上的特定患者，考虑对严重脱位的肱骨近端骨折进行手术治疗是安全和合理的。 class = “标题“>证据级别 class =” Para“>根据《欧亚经济与管理委员会工作组，IV级。

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