75 歳以上の高齢者の上腕骨近位部骨折に対する手術成績
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<B>Background:</B> The purpose of this study is to evaluate the clinical results of surgical treatment for proximal humeral fractures in patients over 75 years old.<BR><B>Methods:</B> 47 elderly patients who were over 75 years-old were followed for more than 6 months after 2007. Open reduction and internal fixation (ORIF group), in which patients were treated with locking compression plate (LCP group) or interlocking nail (N group), consisted of 19 shoulders (1 man, 18 women) in LCP group and 20 shoulders (4 men, 16 women) in N group, and there were 8 shoulders (8 women) in humeral head replacement (HHR group). All patients were evaluated with Neer classification, JOA score, range of motion of flexion and external rotation. Mann-Whitney's U test was used for Statistical analysis.<BR><B>Results:</B> Postoperative flexion angle was 111.6 degrees in LP group, 110.8 degrees in N group, and 66.9 degrees in HHR group. Postoperative external rotation angle was 32.1 degrees in LP group, 30.8 degrees in N group, and 6.3 degrees in HHR group.<BR><B>Discussion and conclusion:</B> The clinical results of surgical treatment for proximal humeral fractures in patients over 75 years old were not better than that of previous reports in younger patients. ORIF group has better clinical results rather than HHR group. ORIF is desirable if possible, however, when ORIF is impossible because of comminuted fracture or osteoporosis, HHR must be chosen. Furthermore, in elderly patients, complications and dementia lead to difficulty of rehabilitation.
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