摘要
目的：通过对比分析人工肱骨头置换与常规通过骨折复位内固定治疗肱骨近端粉碎性骨折的临床最终效果,探讨治疗老年肱骨近端粉碎性骨折的比较适合方法。方法：2006年12月至2013年12月在医院骨科因肱骨近端粉碎性骨折手术的老年病例57例并分为两组：人工肱骨头置换组（31例）与常规骨折复位内固定组（26例）。采用Neer评分标准比较两种方法的治疗效果和并发症情况。结果：平均随访24个月（18~30个月）,进行人工肱骨头置换组31例,疗效优15例、良10例、可4例,差2例,优良率80.65%。复位内固定组26例,疗效优11例、良4例、可7例、差4例,优良率57.69%。两组优良率有统计学差异（P〈0.05）。结论：通过疗效对比,采用人工肱骨头置换术的治疗方法有着术后疼痛时间短,肩关节功能恢复快的优点,尤其是伴有骨折碎片多疏松较明显的老年患者,人工肱骨头置换可以作为首选。
Objective: To compare the clinical efficacies of humeral head prosthesis with internal fixation in the treatment of comminuted proximal humeral fractures and explore a better method. Methods: 57 cases of comminuted proximal humeral fractures in elderly patients in the First Hospital of Yangtze University from Dec. 2006 to Dec. 2013 had been divided into 2 groups: 31 cases in the group with humeral head replacement and 26 cases in the group with internal fixation. Neer scores had been used to compare curative effects and complications. Results: In the average follow-up of 24-month( from 18 to 30 months) there were 15 cases with excellent efficacy in the former group,10 with good efficacy,4 with moderate efficacy and 2 with poor efficacy,the excellent rate 80. 65%,while in the latter group 11 cases with excellent efficacy,4 with good efficacy,7with moderate efficacy and 4 with poor efficacy,the excellent rate 57. 69%. There was a statistically significant difference( P< 0. 05). Conclusion: Replacement of humeral head prosthesis can promote the shortterm functional recovery of the shoulder with minimal surgical complications. Especially humeral head replacement is the first choice for elderly patients with severe osteoporosis.
关键词
肱骨近端
粉碎性骨折
人工肱骨头置换
内固定
proximal humeral
comminuted fractures
humeral head replacement
internal fixation
