锁定钢板与交锁髓内钉治疗老年肱骨近端骨质疏松性骨折患者的效果比较

Effect comparison of locking plate and interlocking intramedullary nail in the treatment of elderly patients with proximal humeral osteoporotic fracture

目的探讨锁定钢板与交锁髓内钉对老年肱骨近端骨质疏松性骨折的疗效。方法选取2017年2月~2019年2月福建医科大学附属闽东医院收治的83例老年肱骨近端骨质疏松性骨折患者为研究对象,按照随机数字表法分成髓内钉组(41例)与钢板组(42例)。钢板组开展锁定钢板治疗,髓内钉组则开展交锁髓内钉治疗。比较两组临床疗效,各项手术指标,术后并发症发生情况。结果髓内钉组总有效高于钢板组,差异有统计学意义(P<0.05)。髓内钉组手术时长、住院时长以及骨性愈合时间均短于钢板组,差异有统计学意义(P<0.05);髓内钉组的术中失血量少于钢板组,差异有统计学意义(P<0.05)。两组术后骨折畸形愈合、肩关节疼痛、骨髓炎、感染等各项并发症发生率比较,差异均无统计学意义(P>0.05)。结论交锁髓内钉治疗老年肱骨近端骨质疏松性骨折的疗效更佳,可促进患者骨折早日愈合,且不会增加并发症发生风险。

Objective To explore the curative effect of locking plate and interlocking intramedullary nail in the treatment of elderly patients proximal humeral osteoporotic fracture.Methods A total of 83 elderly patients with proximal humerus osteoporotic fractures admitted to Affiliated Mindong Hospital of Fujian Medical University from February 2017 to February 2019 were included in the study.According to the random number table method,they were divided into intramedullary nail group(41 cases)and steel plate group(42 cases).Locking plate treatment was carried out in the steel plate group,while interlocking nail treatment was carried out in the intramedullary nail group.The clinical efficacy,operation indexes and postoperative complications of the two groups were compared.Results The overall effective rate of intramedullary nail group was higher than that of steel plate group,the difference was statistically significant(P<0.05).The operation time,hospitalization time and bone healing time of intramedullary nail group were shorter than those of steel plate group,the differences were statistically significant(P<0.05).The intraoperative blood loss of intramedullary nail group was less than that of the steel plate group,the difference was statistically significant(P<0.05).The incidence rates of postoperative complications such as malunion of fracture,shoulder pain,osteomyelitis and infection were compared between the two groups,the differences were not statistically significant(P>0.05).Conclusion Interlocking intramedullary nail in the treatment of elderly patients with proximal humerus osteoporotic fracture has a better effect,can promote fracture healing as soon as possible,and does not increase the risk of complications.