肱骨近端锁定钢板与髓内钉治疗肱骨外科颈骨折的临床对比研究

目的分析肱骨近端锁定钢板与髓内钉治疗NeerII型肱骨外科颈骨折的疗效。方法回顾性研究自2009-09—2012—06收治的48例NeerⅡ型肱骨外科颈骨折，其中25例行肱骨近端锁定钢板（PHIL05组）固定，23例行肱骨髓内钉（PHN组）固定。结果PHILOS组手术时间为（110_＋26）min高于PHN组（78±12）min，PHILOS组术中出血量为（96±15）ml高于PHN组（52±10）ml，PHILOS组骨折愈合为（15±4）周，高于PHN组（10±2）周，差异均具有统计学意义（P〈0．05）。2组术后在颈干角比较．差异无统计学意义（P〉0．05）。2组术后肩关节Constant评分比较差异无统计学意义，但PHN组的外展前屈功能稍差。结论肱骨近端锁定钢板与髓内钉在治疗NeerII型肱骨外科颈骨折临床疗效相当，但肱骨近端髓内钉手术创伤更小，有利于骨折愈合。

Comparison of PHILOS and PHN for treatment of Neer II humerus surgical neck fracture

Objective To compare the clinic effect of PHILOS and PHN for the Neer II humerus surgical neck fracture retrospectively. Methods Forty eight patients with Neer 1] humerus surgical neck from September 2009 to June 2012 were reviewed. Twenty five patients were treated with PHILOS. Twenty three patients were treated with PHN. Results The operation time, perioperative blood loss, bone union time of PHILOS group were （110±25）min, （96±15）ml, （15±4）weeks respectively, all of them were significantly longer than those in PHN group, which were （78±12）min, （52±10）ml, （10±2） weeks respectively, there were significant difference （P 〈0.05）. There were no statistical significance on the neck shaft angle and its change （P 〉0.05）. The Constant score had no signiilcancely difference, but the abduction and forward bending was worse in PHN. Conclusion PHILOS and PHN can get the same clinic outcomes for treatment of the Neer II humerus surgical neck, but the PHN is less invasive, and it can promote the bone union.