两种不同方法治疗老年肱骨近端Neer三、四部分骨折的对比分析

Comparative analysis of two different methods for Neer three and four parts fracture of proximal humeral in seniles

目的探讨人工肩关节置换与切开内固定法治疗肱骨近端Neer三、四部分骨折的疗效差异。方法收集本院70例肱骨近端Neer三、四部分骨折的老年患者作为临床研究对象,按手术方式分为人工肩关节组(A组,30例)和锁定接骨板组(B组,40例),观察A、B两组患者在手术中的手术时间、出血量,手术后18个月后患者肩关节Neer评分等情况。结果 A组患者在术中的手术时间、出血量少于B组,差异具有统计学意义(P<0.05)。在术后18个月,A组患者肩关节疼痛、功能及活动度及Neer总评分明显优于B组,差异具有统计学意义(P<0.05)。结论采用人工肩关节治疗老年肱骨近端Neer三、四部分骨折的临床效果优于常规钢板切开复位法,对患者的康复治疗更有优势。

Objective To study the effect of differeences between open reduction and internal fixation and artificial shoulder joint replacement for Neer three and four parts fracture of proximal humeral in seniles. Methods Collected 70 cases of Neer three and four parts fracture of proximal humeral in seniles, then divided them into artificial shoulder joint replacement group （group A, 30 cases） and open reduction and internal fixation group （group B, 40 cases）, the op- eration time, intraoperative bleeding and postoperative Neer scores after 18 monthes between two groups were ob- served. Results Operation time and intraoperative bleeding of group A were lower than group B, the difference was statistically significant （P 〈 0.05）. The pain, function and mobility of group A were obviously better than group B after 18 months with, the difference was statistically significant （P 〈 0.05）. Conclusion The clinical effects of artificial shoulder joint replacement for Neer three and four parts fracture of proximal humerus in seniles are better than open reduction and internal fixation, it can be recommended in clinic.