文献类型：期刊文献

中文题名：老年肱骨近端骨折内侧柱重建的研究进展

英文题名：Progress in the research of medial column reconstruction of proximal humerus fractures in the elderly

作者：姚川江[1];张宏伟[2];张晓刚[2];于海洋[2];谢飞洋[1];马涛[1];陈钵[1];权祯[1]

第一作者：姚川江

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃中医药大学附属医院,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2022

卷号：35

期号：3

起止页码：300

中文期刊名：中国骨伤

外文期刊名：China Journal of Orthopaedics and Traumatology

收录：CSTPCD;;Scopus;CSCD:【CSCD_E2021_2022】；PubMed;

基金：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)。

语种：中文

中文关键词：肱骨骨折;骨重建;老年人;综述

外文关键词：Humeral fractures;Bone remodeling;Aged;Review

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。
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.