老年肱骨近端骨折内侧柱重建的研究进展
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作者Author单位AddressE-Mail
姚川江 YAO Chuan-jiang 甘肃中医药大学, 甘肃 兰州 730000 The Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China  
张宏伟 ZHANG Hong-wei 甘肃中医药大学附属医院, 甘肃 兰州 730000  
张晓刚 ZHANG Xiao-gang 甘肃中医药大学附属医院, 甘肃 兰州 730000 zxg0525@163.com 
于海洋 YU Hai-yang 甘肃中医药大学附属医院, 甘肃 兰州 730000  
谢飞洋 XIE Fei-yang 甘肃中医药大学, 甘肃 兰州 730000 The Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China  
马涛 MA Tao 甘肃中医药大学, 甘肃 兰州 730000 The Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China  
陈钵 CHEN Bo 甘肃中医药大学, 甘肃 兰州 730000 The Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China  
权祯 QUAN Zhen 甘肃中医药大学, 甘肃 兰州 730000 The Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China  
期刊信息:《中国骨伤》2022年,第35卷,第3期,第300-304页
DOI:10.12200/j.issn.1003-0034.2022.03.019
基金项目:甘肃省中医药管理局科研项目(编号:GZK-2019-37);兰州市科技科技发展计划项目(编号:2017-4-78);2020年甘肃省高等学校创新能力提升项目(编号:2020B-149)
中文摘要:肱骨近端内侧柱是肱骨头内下方的一段连续骨皮质区域,该区域自被提出以来,越来越受到临床和科研的重视。研究发现它有增加内固定的稳定性,维持肱骨头高度,防止内翻,以及降低螺钉穿出的风险等作用,生物力学研究也表明,内侧柱在增加锁定钢板的刚度、抗扭转力、抗剪切力等方面有突出的表现。虽然有诸多好处,但它的概念、具体区域尚未有统一的定义,并且现有的分型未涉及内侧柱,还需更多的研究来提供支撑。内侧柱重建的方式主要包括锁定板联合肱骨距螺钉支撑、锁定钢板联合植入骨支撑、内外侧双钢板联合支撑、锁定板联合骨水泥、肱骨笼,这几种方式各有其特点,但会增加手术的成本以及带来新的并发症,如何确定最佳的重建方式是未来研究的重点之一。
【关键词】肱骨骨折  骨重建  老年人  综述
 
Progress in the research of medial column reconstruction of proximal humerus fractures in the elderly
ABSTRACT  The proximal medial column of the humerus is a continuous cortical region in the inner and lower part of the humerus head,which has attracted more and more attention in clinical and scientific research since it was proposed. It has been shown to increase the stability of internal fixation,maintain the height of the humeral head to prevent varus,and reduce the risk of screw penetration. Biomechanical studies have also shown that the medial column has an outstanding performance in increasing the stiffness,torsion resistance,and shear resistance of the locking plate. Although it has many benefits,there is no unified definition of its concept and specific region,and the existing classification does not include the medial column,therefore more researches are required to provide supporting information. The methods of medial column reconstruction mainly include locking plate combined with talus screw,locking plate combined with bone grafting,internal and external double plate combined support,locking plate combined with bone cement,and humeral cage. These methods have their own characteristics,however they will increase the cost of surgery and bring new complications. How to determine the best way of reconstruction is one of the focuses of future research. In this review,the concept of the proximal medial humerus column,the role of maintaining internal fixation,the role of biomechanics and the reconstruction methods are reviewed.
KEY WORDS  Humeral fractures  Bone remodeling  Aged  Review
 
引用本文,请按以下格式著录参考文献:
中文格式:姚川江,张宏伟,张晓刚,于海洋,谢飞洋,马涛,陈钵,权祯.老年肱骨近端骨折内侧柱重建的研究进展[J].中国骨伤,2022,35(3):300~304
英文格式:YAO Chuan-jiang,ZHANG Hong-wei,ZHANG Xiao-gang,YU Hai-yang,XIE Fei-yang,MA Tao,CHEN Bo,QUAN Zhen.Progress in the research of medial column reconstruction of proximal humerus fractures in the elderly[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):300~304
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