人工肱骨头置换治疗肱骨近端粉碎性骨折

The Treatment of Proximal Humeral Comminuted Fracture with Artificial Humeral Head Replacement

目的：探讨人工肱骨头置换手术治疗肱骨近端粉碎性骨折的疗效.方法：将2015年1月1日～2017年1月1日在本院接受治疗的40例肱骨近端粉碎性骨折患者计算机随机分成2个小组,20例/组.分别实施锁定钢板内固定手术（对照组）和人工肱骨头置换手术（观察组）.对比2组临床指标和肩关节活动度.结果：观察组患者术中失血量195.52±52.16ml、手术时间86.52±10.13分钟、术后引流量54.51±9.31ml,3项临床指标以及术后肩关节梳头活动度3.51° ±0.30°、外旋活动度42.11° ±4.63°、前屈活动度92.64° ±7.42°、外展活动度91.63° ±9.54°,都比对照组更佳,其统计学显示有较大的差异（P〈0.05）.结论：人工肱骨头置换手术治疗肱骨近端粉碎性骨折效果显著。

Objective： ： To investigate the effect of artificial humeral head replacement in the treatment of proximal humeral comminu- ted fracture. Methods： Forty cases of proximal comminuted comminuted fractures of the humerus who were treated in our hospital from 2015.01.01 - 2017.01.01 were randomly divided into two groups, 20 cases each group. The control group underwent internal fixation with locking plate while the observation group underwent artificial humeral head replacement. Then the clinical indexes and shoulder joint activities were compared with the two groups. Results： The intraoperative blood loss （195.52 ± 52.16）ml, operation time （86.52 ± 10. 13 ）rain, postoperative drainage volume （54.51 ± 9.31 ）ml and postoperative combing activity of shoulder joint （3.51 ± 0.30°）. The degree of external rotation （42.11 ± 4.63 ° ）, ttexion activity （ 92.64 ±7.42 ° ） and outreach activity （ 91.63 ± 9.54° ） were better than those of the control group, the statistics have obvious differenees.（ P 〈 O. 05 ）. Conclusion： The artificial humeral head replacement surgery for the treatment of proximal humeral comminuted fracture effect was significant and obvious.