肱骨近端复杂骨折老年患者手术治疗临床分析

目的研究肱骨近端锁定内固定系统（proximal humerus internal locking system,PHILOS）、肱骨近端锁定钢板（locking proximal humerus plate,LPHP）对于肱骨近端复杂骨折老年患者的治疗效果。方法将作者医院2010-07/2012-07月收治的92例老年肱骨近端复杂骨折的患者作为研究对象,随机分为PHILOS组、LPHP组,每组各46例,比较两组的治疗效果。结果与LPHP组相比PHILOS组手术时间较短、术中出血量相对少,骨折愈合时间短,两组相比差异具有统计学意义（P〈0.01）;两组患者术后,疼痛症状改善,日常生活逐渐恢复,关节活动能力提高;PHILOS组上述指标的改善程度优于LPHP组（P〈0.01）;PHILOS组治愈率为97.83%高于LPHP组的80.43%（χ2=7.1805,P〈0.01）;两组并发症的发生情况比较差异具无统计学意义（χ2=1.0110,P=0.3417）。结论 PHILOS与LPHP相比骨折愈合时间短、患者术后疼痛减轻、运动功能恢复快,且治愈率高;对于治疗老年肱骨近端复杂骨折具有一定的临床意义。

Curative Effect of Locking Proximal Humeral Plate and Proximal Humerus Locking Fixation System for the Treatment of Proximal Humeral Fractures in the Elderly Patients

Objective To research the proximal humerus locking fixation system （PHILOS）, a locking proximal humeral plate （LPHP） in the treatment of elderly patients with complex proximal humeral fractures.Methods From Jan- uary 2012 to July 2013, 92 elderly patients with humerus complicated proximal fracture were researched and were ran- domly divided into PHILOS and LPHP groups with 46 cases in each group.The treatment effect of the two groups were compared.Results Compared with LPHP group, PHILOS group had shorter operation time, less intraoperative blood loss, and shorter fracture healing time（P〈0.01）.Postoperative pain symptoms were improved, daily life were gradually restored, and joint activity ability were raised,which were better in PHILOS group （P〈0.01）.The cure rate was 97.83 in PHILOS group which was higher than 80.43% in LPHP group （P〈0.01）.Both groups had few complications （P = 0.3417） . Conclusion PHILOS is better than LPHP with shorter fracture healing time, better postoperative pain release, faster movement function recovery, and higher cure rate, which has a certain clinical significance for treatment of proximal humerus fractures in elderly patients.