锁定接骨板与人工肩关节治疗老年肱骨近端NeerⅢ、Ⅳ部分骨折疗效比较分析

Comparison of Locking Humerus Plate and Artificial Shoulder Arthroplasty for NeerⅢ,Ⅳ Part of Proximal Humeral Fractures in the Elders

目的比较分析锁定接骨板与人工肩关节治疗老年肱骨近端NeerⅢ、Ⅳ部分骨折的疗效差异。方法收集河北大学附属石油物探中心医院骨科2008年1月至2010年9月收治的64例老年肱骨近端粉碎性骨折病例,根据手术方式不同分为人工肩关节手术组(HHR组)和切开复位锁定接骨板组(ORIF组),对两组Constant评分以及Neer评分情况进行比较分析。结果 HHR组的术后1年和术后2年的Constant总评分分别为(79.35±5.73)分和(83.15±6.07分),高于ORIF组同时间点的Constant总评分(70.84±6.45)分和(78.24±5.67)分,两组同时间点总评分比较差异具有统计学意义(P<0.05);HHR组的术后1年和术后2年的Neer总评分分别为(79.67±4.18)分和(87.31±3.47)分,高于ORIF组同时间点的Neer总评分(75.15±1.82)分和(82.24±2.42)分,两组同时间点总评分比较差异具有统计学意义(P<0.05)。结论与锁定接骨板相比,人工肩关节治疗老年肱骨近端NeerⅢ、Ⅳ部分,患者耐受性好,功能恢复快,值得临床推广。

Objective To compare curative effect of locking humerus plates and artificial shoulder joint treatment of Neer Ⅲ.Ⅳpart of proximal humeral fractures in the elders.Methods A total of 64 cases of proximal humerus fracture were collected from Affiliated Staff Hospital of Petroleum Prospecting of Hebei University orthopedic department during Jan.2008 and Sep.2010,and divided into humeral head replacement group（HHR group） and open reduction and internal fixation group（ORIF group）according to operation method.Constant score and Neer score of the two groups were compared and analyzed.Results Constant total score of HHR group in 1 year and 2 years after operation were （79.35±5.73） and （83.15±6.07） respectively,which were significantly higher than （70.84±6.45） and （78.24±5.67） of ORIF group at the same time point（P〈0.05）;Neer total score of HHR group in 1 year and 2 years after operation were （79.67±4.18） and （87.31±3.47） respectively,which were significantly higher than （75.15±1.82） and （82.24±2.42） of ORIF group at the same time point（P〈0.05）.Conclusion Compared with locking plates,artificial shoulder joint treating the elderly Neer Ⅲ,Ⅳ part proximal humeral fractures,are featured with good patient tolerance and rapid recovery,which is worthy to be spread in clinical.