人工肱骨头置换术与肱骨近端锁定钢板内固定治疗肱骨近端复杂骨折的临床对比观察

Comparative Observation on Humeral Head Replacement Surgery with Proximal Humeral Locking Plate Fixation of Complex Proximal Humeral Fractures

目的:探讨人工肱骨头置换术与肱骨近端锁定钢板内固定治疗肱骨近端复杂骨折的临床疗效。方法:随机选取笔者所在医院收治的102例肱骨近端复杂骨折患者,根据Neer分类将研究对象按随机数字表法分为内固定组(n=62例)和置换组(n=40例)。内固定组患者给予钢板内固定治疗,置换组患者给予人工肱骨头置换治疗。依照Neer评分,对两组的疗效进行记录和比较。结果:内固定组疗效评分为(85.3±3.6)分,置换组疗效评分为(84.2±2.7)分,两组比较差异无统计学意义(P>0.05);内固定组优良率为84%,置换组为85%,两组比较差异无统计学意义(P>0.05)。结论:人工肱骨头置换术与肱骨近端锁定钢板内固定在治疗肱骨近端复杂骨折时均有良好的临床效果,因此需选取合适的方案治疗,充分考虑患者的适应证、术后康复和高效的肩袖重建。

Objective：To investigate the clinical efficacy of complex proximal humeral fracture with humeral head replacement surgery and locking proximal humerus plate fixation.Method：We randomly selected 102 cases of complex proximal humeral fractures in our hospital,according to the Neer classification method they were divided into internal fixation group（n=62） and replacement group（n=40）.Internal fixation group patients received a fixed plate fixation,while replacement group received the humeral head replacement.Recorded and compared the efficiency between two groups according to Neer score. Result：Internal fixation group efficacy score was （85.3±3.6）,replacement group was （84.2±2.7）,the difference had no statistically significant（P〉0.05）;The excellent rate of internal fixation group was 84%,while replacement group was 85%,the difference had no statistical significant（P〉0.05）.Conclusion：The humeral head replacement surgery with locking proximal humerus plate fixation in the treatment of complex proximal humeral fracture has good clinical results,thus the need to select the appropriate regimen,gives full consideration to the patient＆#39;s indications,postoperative rehabilitation and efficient the rotator cuff reconstruction.