肱骨近端锁定钢板内固定治疗肱骨近端骨折的临床疗效及不良反应观察

目的]探讨肱骨近端锁定钢板（LPHP）内固定治疗肱骨近端骨折（Proximal humeral fractures,PHF）的疗效及其不良反应.方法]选择2011年4月至2014年1月在本院骨科接受治疗的PHF患者46例,按照治疗方式的不同将患者分为观察组和对照组,每组各23例.观察组接受LPHP内固定治疗,而对照组仅接受保守治疗.术后6个月采用Neer肩关节功能评分系统对两组患者进行评分,评价患者近期疗效并统计两组患者不良反应发生情况.结果]观察组疼痛、功能、运动范围和解剖复位得分分别为（31.7±3.5）分、（24.6±3.2）分、（18.1±2.3）分和（8.5±1.2）分,总得分（82.1±4.7）分,对照组为（26.3±4.2）分、（20.4±2.8）分、（13.6±3.3）分和（6.0±2.1）分,总得分（68.7±7.4）分;观察组优良率为82.6％（19/23）,对照组优良率为52.2％（12/23）;观察组1例切口感染、1例肩关节活动受限,不良反应发生率为8.7％,对照组3例股骨头坏死,5例肩关节活动受限,不良反应发生率为34.8％.上述各项指标两组比较差异均具有统计学意义（P＜0.05）.结论]LPHP内固定治疗PHF的疗效显著,能明显改善患者肩关节功能,且安全可靠,值得在临床上进一步推广.

Observation of Clinical Efficacy and Adverse Reactions of Selective Treatment with Locking Proximal Humeral Plate for Proximal Humeral Fractures

Objective]To observe and explore the efficacy and adverse reactions of locking proximal humeral plate（LPHP） for the treatment of proximal humeral fractures（PHF）.Methods] A total of 46 patients with PHF treated in orthopedic department of our hospital from April 2011 to Jan.2014 were selected.Ascording to different treatment methods,all patients were divided into observation group and control group with 23 patients in each group.The observation group was treated with LPHP surgery,while the control group were treated with conservative treatment.Neer shoulder function score system was used to evaluate the efficacy of two groups at 6 months after treatment and the occurrence of adverse events in the two groups were recorded.Results] The scores of pain,function,range of motion and anatomic reduction in observation group were （31.7 ± 3.5）,（24.6 ± 3.2）,（18.1 ± 2.3） and （8.5±1.2） points respectively,and the total scores were （82.1 ± 4.7） points,while those in control group were （26.3 ± 4.2）,（20.4 ±-2.8）,（13.6 ± 3.3） and （6.0 ± 2.1） points respectively,and the total score was （68.7 ± 7.4） points.The excellence rate in observation group and control group was 82.6％ （19/23） and 52.2％（12/23）,respectively.In observation group,1 patient had wound infection and 1 patient had the limited shoulder mobility,and the incidence of adverse reactions was 8.7％.In control group,3 patients had osteonecrosis and 5 patients had the limited shoulder mobility,and the incidence of adverse reactions was 34.8％.There were significant differences in above items between two groups（P ＜0.05）.Conclusion] LPHP for the treatment of PHF has significant efficacy,and can obviously improve patients＇ shoulder function,and is safe and reliable.Therefore,it is worthy of further promotion in clinical practice.