锁定钢板内固定与人工肱骨头置换治疗老年复杂肱骨近端骨折的比较研究  

Comparison of locking plate internal fixation versus hemiarthroplasty for treatment of the elderly complex proximal humeral fractures

作　　者：陈豪杰[1] 陈云丰[1] 王磊[1] 李琦[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科

出　　处：《老年医学与保健》2015年第3期162-164,共3页Geriatrics & Health Care

摘　　要：目的比较锁定钢板（PHILOS）切开复位内固定和人工肱骨头置换（HA）治疗复杂肱骨近端骨折的疗效差异。方法回顾性分析2010年6月-2013年6月行手术治疗的肱骨近端3部分和4部分骨折（或伴脱位）47例，其中PHILOS组29例和HA组18例。观察记录患术后3m、6m及12m的Constant—Murley评分和DASH评分，术后12m的SF-36量表评分以及术后并发症和二次手术情况。结果两组术后3rn的Constant-Murley评分总分、DASH评分、术后12m的SF-36量表评分、两组术后并发症的差异无统计学意义，而术后6m、术后12m的Constant-Murley评分总分、DASH评分PHILOS组优于HA组，PHILOS组2例行二次手术，HA组无二次手术。结论与人工肱骨头置换相比，锁定钢板治疗复杂肱骨近端骨折具有更好的功能结果，相近的并发症，生活质量相似。Objective To evaluate the clinical outcomes of locking plate internal fixation versus hemiarthroplasty in the treatment of the elderly complex proximal humeral fractures. Methods From June 2010 to June 2013, 47 cases with 3 part and 4 part fractures （or with dislocation） of the proximal humerus were treated with locking plate internal fixation or hemiarthroplasty, 29 cases were in locking plate internal fixation group, and 18 cases were in hemiarthroplasty group. The Constant-Murley scores and DASH scores of 3 months, 6 months and 12 months were recorded postoperatively. The SF-36 scores of 12 months postoperation, complications and secondary surgery were also recorded, respectively. Results There was no statistical differences between the locking plate internal fixation group and the hemiarthroplasty group in the Constant-Murley scores, DASH scores of 3 months postoperation, the SF-36 scores of 12 months postoperation and com- plications. The patients with locking plate internal fixation had better Constant-Murley score and DASH scores of 6 months and 12 months postoperation. 2 cases with locking plate internal fixation had secondary surgery, but the patients with hemi- arthroplasty had no secondary surgery. Conclusions Compared with hemiarthroplasty, patients with locking plate internal fixation could obtain more favorable functional outcomes with similar complication and life quality.

关 键 词：肱骨近端骨折 锁定钢板 内固定 人工肱骨头置换 

分 类 号：R687.3[医药卫生—骨科学]