老年肱骨外科颈骨折两种内固定治疗的疗效分析

Analysis of Curative Effect of Two Kinds of Internal Fixation in the Treatment of Elderly Patients with Surgical Neck Fracture

目的：分析对比老年肱骨外科颈骨折采用两种内固定方式的疗效。方法：选取2008年3月-2013年12月96例60岁以上老年肱骨外科颈骨折患者,随机分为普通钢板组和锁定钢板组,各48例,分别采用普通三叶草钢板和锁定钢板（LCP）内固定治疗,比较两组疗效。结果：术后随访8~24个月,平均（11.21±3.10）个月,均一期愈合,无感染病例。普通钢板组出现2例肱骨头坏死,6例螺钉松动,4例断钉,7例腋神经损伤,关节僵硬11例;锁定钢板组无一例肱骨头坏死及螺钉松动,腋神经损伤3例,关节僵硬5例。根据肩关节ASES评分,普通钢板组平均（71.78±2.31）分,锁定钢板组平均（81.71±1.72）分,差异有统计学意义（P〈0.05）。结论：使用锁定钢板治疗60岁以上老年肱骨外科颈骨折术后肩关节恢复效果比使用普通钢板的效果好。

Objective： To compare the effect of two kinds of internal fixation in the treatment of elderly humeral surgical neck fracture.Method： 96 cases over 60 years old with fracture of surgical neck of humerus from March 2008 to December 2013 were selected, they were randomly divided into the ordinary plate group and the locking plate group, 48 cases in each group, the two groups were treated respectively with ordinary steel plate and locking compression plate（LCP） fixation.The effects in two groups were compared.Result： The patients were followed up for 8-24 months, and the average was （11.21 ± 3.10）months, and the primary healing was healing by first intention, there was no infection.There were 2 cases of humeral head necrosis, 6 cases of screw loosening, 4 cases of screw loosening, 7 cases of axillary nerve injury, and 11 cases of joint stiffness in the ordinary plate group.There were no humeral head necrosis and screw loosening, 3 cases of axillary nerve injury and 5 cases of joint stiffness in the locking plate group.According to the ASES score of shoulder joint, the ordinary plate group was 71.78 ± 2.31, the locking plate group was 81.71 ± 1.72.Comparing the two groups of postoperative shoulder score, there was statistical significance （P〈0.05）. Conclusion： The recovery effect of locking compression plate（LCP） fixation in the treatment of 60 years old humeral surgical neck fracture is better than that of ordinary steel plate.