背景：肱骨远端骨折是一种常见的骨折类型，临床对老年患者进行治疗的时候，可采用保守治疗或者金属植入物内固定治疗，但关于具体治疗方案的选择，目前尚缺乏明确的定论。目的：探讨钛合金植入物内固定治疗老年肱骨远端骨折的临床修复效果和生物相容性。方法：纳入老年肱骨骨折患者41例，均为儋州市第一人民医院2011年7月至2014年7月收治的住院患者。按照患者意愿选择修复方案，其中对照组22例实施常规保守治疗，观察组19例实施钛合金植入物内固定治疗。治疗后随访12个月，观察两组的肘关节活动度和肘关节功能恢复效果以及不良反应发生情况，并进行比较。结果与结论：经保守治疗和内固定治疗之后，两组患者的肩关节活动度各项指标评分及总分较之治疗前均得到显著的提高(P <0.05)；且治疗后观察组的肩关节活动度各项指标评分及总分均显著高于对照组(P <0.05)。经疗效评定，对照组评定为优、良的分别有4例和3例，观察组为8例和4例，对照组的治疗优良率显著低于观察组(P <0.05)。观察组患者钛合金植入取出时内固定物周围软组织有2例存在轻微的炎性增生现象，其余患者均未出现炎性增生或者组织包膜等。观察组术后有1例患者出现尺神经支配区麻木，实施营养神经治疗之后麻木感觉消失。1例患者出现切口感染，实施积极抗生素治疗之后感染得到有效的控制，未引起严重后果。经随访，所有患者未出现骨折不愈合或者内固定物松动等。结果表明，钛合金植入物内固定治疗老年肱骨远端骨折可以获得较之保守治疗更好的修复效果，有效改善患者的肘关节功能，且钛合金材料具有良好的生物相容性。%BACKGROUND:Fracture of the distal humerus is a common type of fracture. Conservative treatment or metal implant fixation can be used during the clinical treatment of elderly patients, but the choice of specific treatment options stil lacks of clear conclusion. OBJECTIVE:To explore the clinical repair effect and biocompatibility of titanium aloy implant internal fixation for aged patients with distal humeral fractures. METHODS: A total of 41 elderly patients with humeral fractures, who were hospitalized in Danzhou Municipal First People’s Hospital from July 2011 to July 2014, were enroled in this study. In accordance with the wishes of patients, repair program was selected. 22 patients in the control group received conservative treatment. 19 patients in the observation group received titanium aloy implant fixation. After 12 months of folow-up, elbow joint activity, elbow joint function recovery and adverse reactions were observed and compared in the two groups. RESULTS AND CONCLUSION: After conservative treatment and internal fixation, each index score and total score of range of motion of shoulder joint were significantly higher in the two groups as compared with pre-treatment (P < 0.05). Each index score and total score were significantly higher in the observation group than in the control group (P < 0.05). Curative effect evaluation results showed four excelent patients and three good patients in the control group, eight excelent patients and four good patients in the observation group. The excelent and good rate was significantly lower in the control group than in the observation group (P < 0.05). Two patients suffered from mild inflammatory hyperplasia during taking out the fixator in the observation group, and the remaining patients did not affect inflammatory hyperplasia or capsular tissue. In the observation group, after surgery, one case experienced numbness of the ulnar nerve, which disappeared after treatment with trophic nerve. One case suffered from wound infection, which was controled by antibiotic treatment, and did not induce a serious outcome. After folow-up, none of them had nonunion or internal fixation loosening. The results show that titanium aloy implant fixation for the treatment of distal humerus fractures can get better repair effect compared with conservative treatment, can effectively improve the elbow joint function, and titanium aloy material has good biocompatibility.
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