Comparison of different internal fixation systems in geriatric humerus surgical neck fractures

LU Xiang-rong; LU Da-ming; JIANG Liang-hua; LU Zhen-liang; XU Xue-ping

doi:10.11659/jjssx.05E023061

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Comparison of different internal fixation systems in geriatric humerus surgical neck fractures

Bone and Joint | 更新时间：2024-09-29

- Comparison of different internal fixation systems in geriatric humerus surgical neck fractures
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 9, Pages: 764-767(2024)
- 作者机构：
  
  江苏大学附属昆山医院创伤骨科，江苏昆山 215300
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.05E023061
  CLC： R687.3
- Published：25 September 2024，
  
  Received：12 May 2023，
- 稿件说明：
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陆向荣,陆大明,蒋梁华等.不同内固定系统在老年肱骨外科颈骨折中的应用对比[J].局解手术学杂志,2024,33(09):764-767.

LU Xiang-rong,LU Da-ming,JIANG Liang-hua,et al.Comparison of different internal fixation systems in geriatric humerus surgical neck fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):764-767.
陆向荣,陆大明,蒋梁华等.不同内固定系统在老年肱骨外科颈骨折中的应用对比[J].局解手术学杂志,2024,33(09):764-767. DOI： 10.11659/jjssx.05E023061.

LU Xiang-rong,LU Da-ming,JIANG Liang-hua,et al.Comparison of different internal fixation systems in geriatric humerus surgical neck fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):764-767. DOI： 10.11659/jjssx.05E023061.

摘要

目的

对比分析桥接组合式内固定系统（OBS）与肱骨近端内锁定系统（PHILOS）治疗老年肱骨外科颈骨折（HSNF）的临床效果。

方法

回顾性分析我院收治的80例老年HSNF患者的临床资料，根据手术方法不同将患者分为2组，其中30例采用OBS治疗的患者纳入OBS组，50例采用PHILOS治疗的患者纳入PHILOS组。比较2组患者手术情况、术后康复情况、血清骨代谢指标[骨钙素（OCN）、Ⅰ型前胶原氨基端前肽（PINP）、碱性磷酸酶（ALP）]水平、骨痂评分、肩关节功能评分[Constant-Murley量表（CMS）评分、Neer评分]、并发症发生率。

结果

OBS组患者手术时间长于PHILOS组，骨折愈合时间短于PHILOS组（

0.05）；OBS组患者术后1个月、3个月血清OCN、PINP、ALP水平高于PHILOS组（

0.05）；OBS组患者术后1个月、2个月、3个月骨痂评分高于PHILOS组（

0.05）；OBS组患者术后1个月、3个月CMS、Neer评分高于PHILOS组（

0.05）；2组患者术后切口恢复良好，均为Ⅰ级愈合，无伤口感染、骨不连等并发症发生。

结论

与PHILOS比较，应用OBS治疗老年HSNF患者的近期临床效果更佳，且能促进骨折愈合。

Abstract

Objective

To compare and analyze the clinical outcomes of the ortho-bridge system （OBS） and the proximal humeral internal locking system （PHILOS） for the treatment of humeral surgical neck fractures （HSNF） in the elderly.

Methods

A retrospective analysis was conducted on the clinical data of 80 elderly patients with HSNF admitted to our hospital. Patients were divided into the two groups based on different surgical methods， among which 30 patients treated with OBS were included into the OBS group and 50 patients treated with PHILOS were included into the PHILOS group. The operation indicators， postoperative recovery indicators， serum bone metabolism indexes ［osteocalcin （OCN）， N-terminal propeptide of type Ⅰ precollagen （PINP） and alkaline phosphatase （ALP）］， callus score， shoulder joint function scores ［Constant-Murley scale （CMS） score and Neer score］， and incidence of complications of the two groups were compared.

Results

The operation time in the OBS group was longer than that in the PHILOS group， and the fracture healing time was shorter than that in the PHILOS group （

0.05）. The levels of serum OCN， PINP， and ALP 1 month and 3 months after surgery in the OBS group were higher than those in the PHILOS group （

0.05）. The callus scores 1 month， 2 months， and 3 months after surgery in the OBS group were higher than those in the PHILOS group （

0.05）. The CMS and Neer scores 1 month and 3 months after surgery in the OBS group were higher than those in the PHILOS group （

0.05）. The incisions of patients in the two groups recovered well after surgery， achieving grade Ⅰ healing without complications such as wound infection or nonunion.

Conclusion

Compared with PHILOS， the application of OBS in the treatment of elderly patients with HSNF has a better short-term clinical outcome， and can promote fracture healing.

关键词

肱骨外科颈骨折桥接组合式内固定系统肱骨近端内锁定系统肩关节功能安全性

Keywords

humerus surgical neck fracturesortho-bridge systemproximal humerus internal locking systemshoulder functionsafety

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