锁定加压钢板与解剖型钢板内固定治疗肱骨近端骨折疗效比较研究

目的：对比分析锁定加压钢板与解剖型钢板内固定治疗肱骨近端骨折的临床效果，探讨合适的肱骨近端骨折内固定方法。方法对2007年1月至2013年1月苏州市第七人民医院收治的63例肱骨近端骨折患者的临床资料进行回顾性分析，其中31例采用锁定加压钢板固定，32例行解剖型钢板固定。观察术后并发症发生情况，根据Neer评分标准对疗效进行评定。结果锁定加压钢板组25例患者获得有效随访，随访时间6～36个月，平均随访时间16个月；解剖型钢板组29例患者获得有效随访，随访时间7～48个月，平均随访时间26个月。锁定加压钢板组术后肩关节功能Neer评分优良率优于解剖型钢板组，但两组比较，差异无统计学意义（96% vs 90%，P＞0.05）。解剖型钢板组1例患者发生肱骨头坏死、吸收，2例出现螺钉松动、部分拔出。两组均未出现断钉、再骨折移位、骨折不愈合、桡神经损伤、腋神经损伤等术后并发症。结论锁定加压钢板和解剖型钢板内固定均能有效治疗肱骨近端骨折，但锁定加压钢板内固定并发症少，更加安全可靠。

Comparison of therapeutic effects between locking compression plate and anatomical plate fixation in the treatment of proximal humeral fracture

Objective To compare clinical results between locking compression plate （LCP） and anatomical plate （ACP） internal fixation in the treatment of proximal humeral fracture, and to explore the appropriate internal fixation methods for the fracture. Methods From January 2007 to January 2013, 63 patients with proximal humeral fracture were treated by LCP or ACP fixation in the Seventh People＆#39;s Hospital of Suzhou, among them 26 patients underwent LCP fixation （LCP group）, while 37 patients underwent ACP fixation （ACP group）. Postoperative complications were observed, and clinical effects were evaluated by Neer scoring standard. Results In LCP group, 25 patients were followed up for an averge of 16 months （6-36 months）; In ACP group, 29 patients were followed up for an averge of 26 months （7-48 months）. According to Neer scoring criteria,＆amp;nbsp;good-excellent rate in LCP group was better than that in ACP group, but there had no statistical differences between two groups （96% vs 90%, P 〈0.05）. During the follow-up, there were humeral head necrosis and absorption in 1 case and screw loosening and partly pull-out in 2 cases in ACP group. No poseoperative complications such as screw breakage, refracture, displacement, bone nonunion, radial or axillary nerve injury had been obseved in 2 groups. Conclusion Both LCP and ACP fixation are effective for patients with proximal humeral fracture, but LCP treatment in this study shows less postoperative complications and obtain more safe and reliable effects.