不同方法治疗肱骨近端粉碎性骨折的疗效比较

Comparative study of curative effect of different methods in the treatment of comminuted proximal humeral fractures

目的比较不同方法治疗肱骨近端粉碎性骨折的疗效。方法对笔者收治的51例肱骨近端粉碎性骨折患者的临床诊治资料进行回顾性分析,行锁定解剖钢板治疗者30例(A组),行人工肱骨头置换术治疗者21例(B组),分析两组患者的治疗效果。结果 A组患者的治疗优良率为86.7%,与B组的90.5%比较差异无统计学意义(P>0.05);两组患者的Neer肩关节功能评分,差异亦无统计学意义(P>0.05)。结论采用人工肱骨头置换术与锁定钢板治疗法治疗肱骨近端粉碎性骨折的临床效果相当,但对于高龄、严重骨质疏松等患者应采用人工肱骨头置换术治疗。

Objective To compare the curative effect of different methods in the treatment of comminuted proximal humeral fractures. Methods The clinical data of 51 patients with comminuted proximal humeral fractures were retrospectively analyzed, of which 30 were treated with locking plate （group A）, and 21 were treated with humer- al head prosthesis replacement （group B）. The therapeutic effect of the two groups was compared. Results The excel- lent and good rate was 86.7% in group A and 90.5% in group B, with no statistically significant difference between the two groups （P〉0.05）. There was no statistically significant difference between the two groups in Neer shoulder joint function score （P〉0.05）. Conclusion Clinical effect of humeral head replacement and locking plate in comminuted proximal humeral fractures is equivalent, but artificial humerus head replacement is recommended to be used for elder- ly patients and those with severe osteoporosis.