锁定钢板治疗肱骨近端骨折的疗效与年龄、Neer分型的相关性分析

Effect of locking plate in the treatment of proximal humeral fracture and the correlation with age and Neer type

目的:研究锁定钢板治疗肱骨近端骨折的疗效及患者年龄、Neer分型与疗效指标(Constant-Murley肩关节功能评分、X线片参数)的相关性。方法:回顾性分析经肱骨近端解剖锁定钢板内固定治疗的80例肱骨近端骨折患者临床资料,随访1年,分析年龄、Neer分型与Constant-Murley肩关节功能评分及X线片参数的关系。结果:年龄>60岁组术后Constant-Murley肩关节功能评分、颈干角、内翻角、颈干角内翻复位率低于年龄≤60岁组,前者肱骨大结节至钢板顶点的距离更大(P<0.05);Neer分型优良组术后Constant-Murley肩关节功能评分、颈干角、内翻角高于可差组,前者肱骨大结节至钢板顶点的距离更小(P<0.05);年龄与Constant-Murley评分、肱骨大结节至钢板顶点的距离呈独立负相关,而术后Neer评分与颈干角、内翻角、Constant-Murley评分呈独立正相关(P<0.05)。结论:锁定钢板治疗肱骨近端骨折患者术后肩关节功能与X线片参数有明显相关性,具有一定的监测意义。

Objective:To study the effect of locking plate in the treatment of proximal humeral fracture,and the correlation of age and Neer type with therapeutic effect indicators(Constant-Murley shoulder function score and X-ray parameters).Methods:The clinical data of 80 patients with proximal humeral fractures who underwent internal fixation with anatomical locking plate were retrospectively analyzed.The patients were followed up for 1 year.The correlation of age and Neer type with Constant-Murley score and X-ray parameters was analyzed.Results:The Constant-Murley score,collodiaphyseal angle,varus inclination and reduction rate of collodiaphyseal angle varus in the>60 year-old group were lower/smaller than those in the≤60 year-old group.The distance from greater tubercle of the humerus to the apex of the plate was greater in the>60 year-old group(P<0.05).The Constant-Murley score,collodiaphyseal angle and varus inclination in the excellent and good Neer type group were larger than those in the common and poor Neer type group.The distance from greater tubercle of the humerus to the apex of the plate was smaller in the excellent and good group(P<0.05).Age was independently negatively correlated with Constant-Murley score and the distance from greater tubercle of the humerus to the apex of the plate,while postoperative Neer score was independently positively correlated with collodiaphyseal angle,varus inclination and Constant-Murley score(P<0.05).Conclusion:There is an obvious correlation between postoperative shoulder function and X-ray parameters in patients with proximal humeral fractures treated with anatomical locking plate,it has certain monitoring significance.