采用PHILOS与LPHP治疗老年肱骨近端复杂骨折的疗效研究

With LPHP PHILOS beloved or the curative effect of complex treatment of proximal humeral fractures older patients

目的分析肱骨近端内锁定系统(PHILOS)自锁钢板与肱骨近端锁定钢板(LPHP)治疗老年肱骨近端复杂骨折的效果。方法将96例老年肱骨近端复杂骨折患者随机均分为两组,观察组患者采用PHILOS自锁钢板内固定治疗,对照组患者采用LPHP内固定治疗,比较两组的治疗效果。结果观察组患者骨折平均愈合时间为(6.5±3.5)周,对照组患者骨折平均愈合时间为(8.2±3.9)周,观察组早于对照组(t=2.247,P=0.027);观察组患者前驱上举、外旋度数大于对照组患者(t=2.691,P=0.008;t=3.088,P=0.003);观察组患者手术时间、术中出血量、术后疼痛评分均优于对照组患者,差异具有极其显著性(P<0.01);观察组患者优良率为95.84%,优于对照组(81.25%),观察组疗效优于对照组(Z=-2.103,P=0.035);观察组患者不良反应发生率为6.25%,对照组为12.50%,差异无显著性(χ2校正=0.490,P=0.483)。结论老年肱骨近端复杂骨折患者采用PHILOS自锁钢板的复位、固定、早期活动等疗效均优于LPHP,且不良反应少,具有重要参考价值。

Objective To analysis in the proximal humerus locking system （PHILOS beloved or） locking plate with a locking proximal humeral plate （LPHP） in the treatment of proximal humerus elderly the curative effect of complex fractures. Method 96 cases of complex proximal humerus elderly fracture patients were randomly divided into two groups, observation group with PHILOS beloved or locking plate internal ifxation treatment, control group using LPHP internal ifxation treatment, compared two groups of curative effect. Result The average healing time of fracture （6.5±3.5） for weeks, the control group （8.2±3.9） for weeks, the experimental group earlier than the control group （t=2.247, P=0.027）. Lift on precursor observation group, outside readings is greater than the control group （t=2.691, P=0.008;t=3.088, P=0.003）;curative effect observation group was 95.84%, 81.25%in control group, experimental group is better than that of control group （Z=-2.103, P=0.035）;observation group 6.25%incidence of adverse reactions, control group was 12.50%, no statistically signiifcant differences between the two groups （χ2cor ection = 0.490, P = 0.483）. Conclusion Proximal humerus elderly complex fracture were treated by PHILOS beloved or locking plate reduction and ifxation, early activities of curative effect is better than that of LPHP, and side effects of small, have important reference value.