摘要
目的探讨人工肱骨头置换术与肱骨近端锁定钢板内固定(LPPH)治疗老年肱骨近端骨折的临床疗效。方法采用随机双盲法设计将90例老年复杂肱骨近端骨折患者分为人工肱骨头置换术组(置换组)和肱骨近端锁定钢板内固定组(内固定组)各45例,内固定组患者行切开复位LPPH,置换组患者行人工肱骨头置换术。比较两组患者术后Neer功能评分及疗效。结果内固定组手术时间、术中出血量和骨折愈合时间分别为(67.49±10.81)min、(214.81±24.72)ml和(16.27±3.08)周,均显著低于对照组(P<0.05);两组间患者手术优秀率分别达到33.33%和31.11%,两组间差异无统计学意义(P>0.05);内固定组日常生活、活动范围和Neer总评分分别达到(24.52±3.76)分,(25.20±3.87)分和(81.84±3.0)分,显著高于置换组(P<0.05),两组治疗后疼痛评分间差异无显著统计学意义(P>0.05)。结论人工肱骨头置换术与肱骨近端锁定钢板固定治疗老年复杂肱骨近端骨折均能获得理想的治疗效果,肱骨近端锁定钢板内固定手术出血量更少,愈合更快,人工肱骨头置换术术后Neer功能恢复更好,值得推广。
Objective To investigate curative effect of artificial humeral head replacement and the proximal hume- rus locking plate fixation on treatment of senile complex of proximal humeral fractures. Methods 90 patients with senile complex proximal humerus were divided into artificial humeral head replacement group （the fracture replacement group= 45） and proximal humerus locking plate fixation group （the internal fixation group=45） by a randomized double blind method. The fracture replacement group treated with open reduction and the internal fixation groups treated with artificial humeral head replacement. The operation situation, postoperative score and efficacy of Neer function of two groups were compared. Results The operation time, bleeding volume and fracture healing time of the internal fixation groups were （67.49±10.81） min, （214.81±24.72） ml and （16.27±3.08） w respectively, were all significantly lower than those of the control group （P〈0. 05）. The operation excellence rate of two groups were reached 33.33% and 31.11±, the difference between the two groups had not statistically significant （P〈0. 05）. The scope of activities of daily life and the total score of Neer of the internal fixation groups were （24. 52±3.76）%, （25.20±3.87） and （81.84±3）% respectively, were all significantly higher than those of the replacement groups （P〈0.05）. The pain score after treatment differ- ences between two groups had no significant statistical significance （P〉0.05）. Conclusion The artificial humeral head replacement and proximal humerus locking plate fixation in the treatment of the senile complex proximal humerus fractures all has ideal treatment effective. The proximal humerus locking plate fixation operation had less blood loss, faster healing while the artificial humeral head replacement for the postoperative functional recovery of Neer better.
出处
《西部医学》
2015年第8期1209-1211,1214,共4页
Medical Journal of West China
基金
四川省卫生厅科研课题(110393)
关键词
老年
复杂肱骨近端骨折
人工肱骨头置换术
肱骨近端锁定钢板固定
Elderly
Complex fractures of proximal humerus
Humeral head replacement
Proximal humerus loc-king plate fixation
