不同内固定方法对肱骨近端骨折的预后影响

目的:探讨不同内固定方法对肱骨近端骨折的预后影响。方法:选取90例因肱骨骨折入院治疗的患者的临床资料进行回顾性分析,按照内固定方法的不同将所有患者分为A组和B组。其中A组为44例,均采用锁定加压钢板治疗;B组为46例,均采用解剖型钢板治疗。比较两组患者术后并发症的发生情况,并且采用Neer评分系统评定肱骨近端骨折治疗后的肩关节功能等级。结果:获得有效随访资料共79份,占87.8%。其中锁定加压钢板组获得有效随访的数量为39,占43.3%;解剖型钢板组获得有效随访的数量为40,占44.4%。根据Neer评定标准,A组患者的肩关节功能Neer评定优良率为92%,显著高于B组87.5%,两组之间差异无统计学意义(x~2=0.131,P0.05)。结论:锁定加压钢板内固定法对肱骨近端骨折预后明显优于解剖型钢板,更有利于患者早期功能锻炼的进行和肩关节功能恢复。

Effect of Different Internal Fixation Methods on the Prognosis of Proximal Humeral Fractures

ABSTRACT Objective: To investigate the effect of different internal fixation methods on the prognosis of proximal humeral frac- tures. Methods: Selected from our hospital 90 cases of hospitalized patients with humeral fractures. Their clinical data were retrospectively analyzed. According to the internal fixation method, all patients were divided into group A and group B. The 44 patients in group A were treated with locking compression plate, while the 46 cases in group B were treated with anatomical plate. The incidence of complications after operation was compared between the two groups, and the Neer scoring system was applied for assessment of shoulder functional class after treatment of proximal humerus fractures. Results: A total of 79 cases were effectively followed up, accounted for 87.8%. There were 39 cases of effective follow-up in the group A, accounted for 43.3%, and 40 cases of effective follow-up in the group B, accounted for 44.4%. According to Neer standard, the patients in group A had excellent and good rate of 92%, higher than that of group B (87.5%). But the difference had no statistical significance between the two groups (x²=0.131, P>0.05). Conclusion: Locking compression plate in- ternal fixation of proximal humerus fractures is more conducive to patients to get early functional exercise and shoulder function recovery than anatomical plate.