人工肱骨头置换术与微创锁定加压钢板内固定治疗对老年肱骨近端骨折患者临床疗效、疼痛及肩关节功能的影响  

The effects of humeral head replacement and internal fixation of minimally invasive locking compression plate on the clinical efficacy,pain and shoulder function of elderly patients with fractures of proximal humerus

作　　者：解金三 陈锋 XIE Jin-san;CHEN Feng(Pingmei Shenma Medical Group General Hospital,Pingdingshan 467000,China)

机构地区：[1]平煤神马医疗集团总医院,河南平顶山467000

出　　处：《实用医院临床杂志》2020年第6期87-90,共4页Practical Journal of Clinical Medicine

基　　金：河南省医学科技攻关计划项目(编号:2016050258)。

摘　　要：目的分析人工肱骨头置换术(HHR)与微创锁定加压钢板内固定术(LCP)对老年肱骨近端骨折患者临床疗效、疼痛及肩关节功能的影响。方法我院收治的90例老年肱骨近端骨折患者,其中43例行HHR治疗(HHR组),47例行LCP治疗(LCP组)。比较术后3、12、16周两组疼痛程度;评估肩关节功能(Constanst评分)和临床疗效(Neer评分);两组手术时间、术中失血量、住院时间、术后并发症及翻修手术情况。结果术后3、12、16周LCP组VAS评分均低于对照组,Neer评分及Constant评分总分均高于HHR组,Neer评分总有效率高于HHR组,并发症发生率低于HHR组(P<0.05)。两组手术时间、术中失血量以及治疗时间比较差异无统计学意义(P>0.05)。两组术后均无翻修情况发生。结论人工肱骨置换术与微创锁定加压钢板内固定治疗均可有效治疗老年肱骨近端骨折,但后者兼具减轻术后头痛、加速肩功能恢复的优势,且并发症发生率小、安全性较高。Objective To analyze the effects of humeral head replacement(HHR)and internal fixation of minimally invasive locking compression plate(LCP)on the clinical efficacy,pain and shoulder function of elderly patients with fractures of proximal humerus.Methods The clinical data of 90 elderly patients with fractures of proximal humerus in our hospital were retrospectively analyzed.Among them,43 patients were treated with HHR(HHR group)and 47 patients were treated with LCP(LCP group).The degree of pain in patients was compared on the 3rd,12 th,and 16 th weeks after surgery.Shoulder joint function(Constanst score)and clinical efficacy(Neer score)were evaluated.The operation time,intraoperative blood loss,hospital stay,postoperative complications and revision surgery were compared between the two groups.Results The VAS scores after 3,12 and 16 weeks of surgery in the LCP group were lower than those in the HHR group(P<0.05).The Neer score,Constant score and total score of the LCP group were higher than those of the HHR group(P<0.05).The excellent and good rate of the Neer score in the LCP group was higher than that in the HHR group(P<0.05).The incidence of postoperative complications in the LCP was lower than that in the HHR group(P<0.05).There was no significant difference in operation time,intraoperative blood loss and treatment time between the two groups(P>0.05).No postoperative revision surgery occurred in either group.Conclusion Both HHR and internal fixation of minimally invasive LCP can effectively treat the fracture of proximal humerus in the elderly.However,the latter has the advantages of reducing postoperative headache and accelerating the recovery of shoulder function,and has low incidence of complications and high safety.

关 键 词：人工肱骨置换术 微创锁定加压钢板内固定治疗 肱骨近端骨折 

分 类 号：R687.3[医药卫生—骨科学]