Objective To review the outcomes of geriatric distal humeral fracture fixed with locking compression plate (LCP). Methods From January 2005 to December 2007, 24 patients (20 females and 4 males) with distal humeral fracture underwent open reduction and internal fixation with LCP. Their average age was 75.5 years old, ranged from 60 to 93 years old. Fracture was caused by injury from fall in 22 cases, by traffic accident in 1 case, and by direct hit in 1 case. There were 12 cases of type A2, 2 cases of type A3, 2 cases of type B1, 2 cases of type C1, 2 cases of type C2, 4 cases of type C3 fractures according to AO/ASIF classification. X-ray films in AP and lateral view were taken preoperatively. CT scan with three dimensional reconstructions was done in more comminuted fracture only. Open reduction with triceps sparingtechnique was used in all except type B fracture, and olecranon osteotomy was considered only in more comminuted C3fracture. The average interval between injury and operation was 3 days (range, 1-6 days). Outcome measures includedpain assessment, range of motion, and Mayo elbow performance score and findings at 1 year follow-up. Results Theaverage length of follow-up was 25 months (range, 12-48 months). All 24 fractures were healed within 6 months with anaverage of about 4 months. At 1 year follow-up, 83% (n=20) of patients felt no pain and 17% (n=4) of patients had mildpain; 83% of patient can gain a flexion range of more than 100°; according to Mayo elbow performance score, the meanscores of type A, B and C fracture groups were 97, 85, and 89, respectively, and the post-operative performance of typeA fracture was significantly better than that of type B and C (P=0.034). Four patients had postoperative compl ications.Conclusion Open reduction and internal fixation of geriatric distal humeral fracture can achieve relatively good functionalresult and bony union despite of age.
目的 探讨不同年龄段老年骨折合并高血压的动态血压变化，评估心脑血管事件发生风险。 方法 将2009年4月－2012年2月入住的184例60岁以上老年骨折合并高血压患者分为低龄老年骨折组（97例，60～79岁）与高龄老年骨折组（87例，≥80岁），对每位患者行动态血压分析。 结果 两组患者平均收缩压均升高，差异无统计学意义（P＞0.05）；但高龄老年骨折组平均舒张压和平均脉压差在全天、日间及夜间均低于低龄老年骨折组，差异有统计学意义（P＜0.05）；高龄老年骨折组血压节律紊乱更明显，心脑血管事件发生率明显高于低龄老年骨折组，差异有统计学意义（P＜ 0.05）。 结论 高龄老年骨折患者血压节律紊乱明显，应及时调整并制定有效的个体化降压方案，积极防止以及血管事情的发生。
Because of the complexity of proximal humeral fractures, the treatment of proximal humeral fractures has always been a challenge for clinicians. The MultiLoc intramedullary nail is a new type of internal fixation device which has been gradually used in the treatment of proximal humeral fractures in recent years. At present, it is mainly used in the Neer two- and three-part fractures, especially surgical neck fractures. Its flexible design can provide personalized and multi-plane fixation for fracture patients, “screw-in-screw” and medial supporting screw can effectively reduce the axial displacement and varus angle of humeral head, and minimally invasive surgical incision can reduce the injury of rotator cuff. This review focuses on the research status and related evidence of the design, operation, prognosis, and postoperative complications of MultiLoc intramedullary nail, in order to provide a theoretical basis for the application of MultiLoc intramedullary nail in fracture treatment, and enhance clinicians’ understanding of MultiLoc intramedullary nail as a new type of internal fixation device.