肱骨近端骨折采用肱骨近端锁定系统钢板与髓内钉固定的效果比较  

Comparison of the Effects of Proximal Humeral Internal Locking System Plate and Intramedullary Nail Fixation for Proximal Humeral Fractures

作　　者：郑伟 张鹏程[1] 魏钰洋 周明柱 ZHENG Wei;ZHANG Pengcheng;WEI Yuyang;ZHOU Mingzhu(Department of Trauma Orthopedic,Ganyu District People's Hospital of Lianyungang City,Lianyungang 222100,Jiangsu,China)

机构地区：[1]连云港市赣榆区人民医院创伤骨科,江苏连云港222100

出　　处：《世界复合医学(中英文)》2025年第1期10-13,18,共5页World Journal of Complex Medicine

摘　　要：目的比较肱骨近端骨折实施肱骨近端锁定系统(proximal humerus internal locking system,PHILOS)钢板与髓内钉固定的效果。方法选取2022年2月—2024年1月连云港市赣榆区人民医院收治的96例肱骨近端骨折患者,根据不同的手术方法分为PHILOS钢板组(48例)和髓内钉组(48例)。PHILOS钢板组进行PHILOS钢板固定,髓内钉组进行髓内钉固定。比较两组手术指标、肩关节活动度、肩关节功能和并发症发生率。结果髓内钉组的手术时间为(78.74±9.96)min、术中出血量为(213.33±36.72)mL、切口长度为(8.52±1.63)cm,均优于PHILOS钢板组的(106.85±12.42)min、(324.86±38.63)mL、(11.44±2.55)cm,差异均有统计学意义(t=12.233、14.498、6.685,P均<0.05)。两组患者的骨折愈合时间、前屈、外展、内旋、外旋活动度、术后3个月、6个月、9个月的肩关节功能评分比较,差异均无统计学意义(P均>0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论临床中PHILOS钢板与髓内钉对肱骨近端骨折均有良好的固定效果,均能有效改善患者的肩关节功能,但相比PHILOS钢板,髓内钉固定的创伤较小,且术中出血量较少,可缩短手术时间。Objective To compare the effect of proximal humerus internal locking system(PHILOS)plate and intramedullary nail in the treatment of proximal humeral fracture.Methods A total of 96 patients with proximal humeral fractures admitted to Ganyu District People's Hospital of Lianyungang City from February 2022 to January 2024 were selected and divided into PHILOS plate group(48 cases)and intramedullary nail group(48 cases)according to different surgical methods.The PHILOS plate group was fixed with PHILOS plate,and the intramedullary nail group was fixed with intramedullary nail.The surgical indexes,shoulder joint activity,shoulder joint function and incidence of complications were compared between the two groups.Results In the intramedullary nail group,the operative time was(78.74±9.96)min,the intraoperative blood loss was(213.33±36.72)mL,and the incision length was(8.52±1.63)cm,which were better than(106.85±12.42)min,(324.86±38.63)mL,(11.44±2.55)cm of PHILOS plate group,and the differences were statistically significant(t=12.233,14.498,6.685,all P<0.05).There were no significant differences in fracture healing time,range of anterior flexion,abduction,internal rotation and external rotation,and shoulder joint function scores at 3 months,6 months and 9 months after surgery between the two groups(all P>0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion In clinical practice,both PHILOS plate and intramedullary nail have good fixation effect on proximal humeral fractures and can effectively improve the shoulder joint function of patients.However,compared with PHILOS plate,intramedullary nail fixation has less trauma,less intraoperative blood loss,and shorter operation time.

关 键 词：肱骨近端骨折 肱骨近端锁定系统钢板 髓内钉 肩关节活动度 肩关节功能 

分 类 号：R687[医药卫生—骨科学]