老年患者肱骨远端关节内骨折切开复位内固定的预后评估

摘要

Objective To assess the clinical efficacy and functional outcome in elderly patients with open reduction internal fixation of intra-articular distal humerus fractures.Methods From 2002 to 2007,20 patients over 65 years old with open reduction internal fixation of intra-articular distal humerus fractures were included in this study.All patients were treated with open reduction internal fixation of their distal humerus.Function outcomes were assessed with the Mayo elbow performance score (MEP),Musculoskeletal Functional Assessment functional questionnaires (MFA) and Disabilities of Arm and Shoulder and Hand (DSAH) score.Results Twenty fractures were healed.The average MEP score was 84 points.The average elbow flexion and extension range was from 21 to 121.The average DSAH score was 37.7 points.The average MFA score was 33.5 points,with a hand score of 34.8 points and self-care score of 31.9 points.One patient received additional treatment for flexion contracture.Conclusion Although intra-articular distal humerus fractures are severely disabling injuries in the elderly patients,good outcomes can be achieved with stable fixation and fracture union.%目的 评估老年患者肱骨远端关节内骨折切开复位内固定的临床疗效和功能预后情况.方法 2002至2007年收治的年龄大于65岁的肱骨远端关节内骨折患者20例,均接受急性肱骨远端切开复位内固定治疗.功能评估采用Mayo肘关节功能评分(MEP)、上肢、肩、手功能障碍(DSAH)评分,整体健康状况评估采用肌肉骨骼功能评定量表(MFA)评分.结果 20例患者的骨折均愈合.平均Mayo肘关节功能评分为84分.肘关节屈伸范围21～121°.平均DSAH评分37.7分,平均骨骼肌肉功能评分33.5分,手的评分为34.8分,自理能力评分为31.9分.1例患者因屈曲挛缩需要进一步治疗.结论 尽管老年患者肱骨远端关节内骨折的致残率较成人高,但大部分老年患者骨折愈合效果良好.老年患者肱骨远端关节内骨折切开复位内固定可以获得满意的疗效.