| 杨继国,胡劲涛,赵晨.半肩置换与锁定钢板治疗骨质疏松性三、四部分肱骨近端骨折的疗效对比.骨科,2018,9(1): 27-31. |
| 半肩置换与锁定钢板治疗骨质疏松性三、四部分肱骨近端骨折的疗效对比 |
| Comparison of hemiarthroplasty vs. locking plate in the treatment of 3- and 4-part osteoporotic proximal humerus fractures |
| 投稿时间：2017-07-09 |
| DOI：10.3969/j.issn.1674-8573.2018.01.006 |
| 中文关键词: 肱骨骨折，近端 骨折固定术，内 半肩置换 锁定钢板 |
| 英文关键词: Humerus fractures, proximal Fracture fixation, internal Hemiarthroplasty Locking plate |
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| 中文摘要: |
| 目的 对比半肩置换与锁定钢板治疗骨质疏松性三、四部分肱骨近端骨折的临床疗效。方法 对2010年1月至2016年1月黄山昌仁医院收治且获得随访的42例Neer三、四部分肱骨近端骨折病人进行回顾性分析。根据内固定方式不同分为两组，半肩置换组15例，锁定钢板组27例。比较两组病人的手术时间、Constant-Murley评分、简明肩关节功能测试（simple shoulder test, SST）评分、肩关节活动范围、术后并发症发生情况。结果 42例病人随访6~15个月，平均8.3个月。半肩置换组无并发症发生，锁定钢板组1例病人出现术后功能障碍，拆除内固定后症状消失。锁定钢板组与半肩置换组的患侧肩关节Constant-Murley评分分别为（71.1±5.3）分、（65.7±5.5）分，肩关节SST评分分别为（8.3±1.2）分、（6.9±1.3）分，SF-36生活质量评分分别为（77.2±5.7）分、（71.5±6.8）分；在前屈、外展、内旋、外旋活动范围上，半肩置换组分别为97.8°±11.8°、75.6°±8.5°、46.5°±5.8°、19.5°±3.1°，锁定钢板组分别为114.1°±16.6°、99.6°±15.5°、59.7°±7.1°、27.1°±2.5°，上述指标中，锁定钢板组均优于半肩置换组，差异均有统计学意义（P均＜0.05）。结论 对于没有肱骨头置换指征的肱骨近端Neer三、四部分骨折，锁定钢板的治疗效果优于半肩置换。 |
| 英文摘要: |
| Objective To compare the clinical efficacy of hemiarthroplasty and locking plate in the treatment of 3- and 4-part osteoporotic proximal humerus patients. Methods From January 2010 to January 2016, 42 patients with 3- and 4-part proximal humerus fractures were analyzed retrospectively. The patients were allocated into two groups according to the type of operation: 15 patients in hemiarthroplasty group, and 27 patients in locking plate group. The operation time, Constant-Murley score, SST score, range of shoulder motion, and complications were compared between the two groups. Results Forty-two patients were followed up for 6-15 months, with an average of 8.3 months. There were no complications in the hemiarthroplasty group. One patient in the locking plate group had postoperative dysfunction, and the symptoms disappeared after the removal of internal fixation. The Constant-Murley score in the locking plate group and hemiarthroplasty group was 71.1±5.3 and 65.7±5.5, SST shoulder scores were 8.3±1.2 and 6.9±1.3, and the SF-36 quality of life scores were 77.2±5.7 and 71.5±6.8 respectively. The flexion, abduction and internal rotation, external rotation range in thehemiarthroplasty group were 97.8°±11.8°, 75.6°±8.5°, 46.5°±5.8°, 19.5°±3.1°, and those were 114.1°±16.6°, 99.6°±15.5°, 59.7°±7.1°, 27.1°±2.5° in the locking plate group respectively (P＜0.05 for all). Conclusion The curative effectiveness of locking plate is superior to hemiarthroplasty in the treatment of 3- and 4-part osteoporotic proximal humerus fractures without humeral head replacement indication. |
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