人工肱骨头置换术治疗26例老年肱骨近端粉碎性骨折临床疗效观察

Observation of clinical effects of artificial humeral head replacement on proximal humerus comminuted fracture in 26 cases of the elderly patients

[背景]观察人工肱骨头置换术治疗老年肱骨近端粉碎性骨折的临床疗效.[病例报告]选择2014年1月至2015年4月间收治的54例老年肱骨近端粉碎性骨折患者的临床资料进行回顾性分析,其中给予人工肱骨头置换术治疗26例,给予锁定钢板内固定治疗28例.采用Neer肩关节功能评分标准比较2种治疗方法术后6个月和12个月时的肩关节功能.所有患者均获得12～16个月随访.术后6个月时2种治疗方法的Neer评分各项指标间差异均无统计学意义（P〉0.05）,术后12个月时人工肱骨头置换术组Neer评分各项指标评分均明显高于锁定钢板内固定术组（P〈0.05）.[讨论]人工肱骨头置换术治疗老年肱骨近端粉碎性骨折中远期疗效优于锁定钢板内固定术.

BACKGROUND To explore the clinical effects of artificial humeral head replacement on proximal humerus comminuted fracture in the elderly patients. CASE REPORTS From January 2014 to April 2015, 54 elderly patients with proximal humerus comminuted fracture were chosen for retrospectively analysis. 26 patients were treated by artificial humeral head replacement and 28 patients were treated by locking plate internal fixation. The shoulder function recovery at 6 months and 12 months after surgery was evaluated by using Neer shoulder joint function score standard. All patients were followed up for 12 to 16 months. There was no significant difference on the Neer score indexes between the two therapeutic methods （P〉0.05） at 6 months after surgery, the Neer score indexes from artificial humeral head replacement group were significantly higher than those from locking plate internal fixation group at 12 months after surgery（P〈0.05）. DISCUSSION The medium-long term efficacy of artificial humeral head replacement is superior to the locking plate internal fixation in the elderly patients with proximal humerus comminuted fracture.