肱骨近端内固定锁定系统与肩关节置换术治疗老年人肱骨近端骨折疗效比较

Efficacy comparison of proximal humeral internal locking system and shoulder arthroplasty in the treatment of proximal humeral fractures in the elderly

目的:比较肱骨近端内固定锁定系统(proximal humeral internal locking system,PHILOS)与肩关节置换术治疗老年人肱骨近端骨折的疗效。方法:回顾性分析2010-07~2019-07我院收治的136例老年肱骨近端骨折患者的临床资料。其中63例采用PHILOS治疗(PHILOS组),73例采用肩关节置换术治疗(关节置换组)。比较两组的骨折愈合时间、负重时间、住院时间、并发症发生率、肩关节功能Neer评分、术中出血量及术后引流量。结果:术后随访9~61(38.0±2.9)个月,两组骨折愈合时间、肩关节功能Neer评分、住院时间、术中出血量及术后引流量比较,差异均无统计学意义(P>0.05)。关节置换组较PHILOS组负重时间早[(45.0±5.7)d vs(48.8±6.1)d]、并发症少(4.11%vs 14.29%),差异均有统计学意义(P<0.05)。结论:肩关节置换术治疗老年人肱骨近端骨折较PHILOS疗效更好,值得临床推荐。

Objective:To compare the efficacy of proximal humeral internal locking system(PHILOS)and shoulder arthroplasty in the treatment of proximal humeral fractures in the elderly.Methods:A total of 136 elderly patients with proximal humeral fractures from July 2010 to July 2015 in our hospital were analyzed retrospectively.63 patients were treated with PHILOS as PHILOS group,and 73 patients were treated with shoulder arthroplasty as joint replacement group.The fracture healing time,weight-bearing time,hospitalization time,complications rate,Neer score of shoulder function,intraoperation blood loss and postoperative drainage volume were compared between the two groups.Results:All patients were followed up for 9-61(38.0±2.9)months.There were no statistically difference in fracture healing time,Neer score of shoulder function,hospitalization time,intraoperative blood loss and postoperative drainage volume between the two groups(P>0.05).There were significantly differences in weight-bearing time[(45.0±5.7)d vs(48.8±6.1)d]and complication rates(4.11%vs 14.29%)between the two groups(P<0.05).Conclusion:Shoulder arthroplasty has better treatment efficacy than PHILOS,which is worthy of clinical recommendation.