肱骨近端粉碎骨折锁定钢板与人工肱骨头置换术治疗的比较分析

目的采用肱骨近端锁定钢板内固定和人工肱骨头置换手术对肱骨近端粉碎性骨折进行治疗,以观察不同手术方式的治疗效果。方法选择我院从2007年7月到2010年12月所收治的肱骨近端骨折患者30例,随机分为两组。置换组患者进行人工肱骨头置换术,固定组患者采用肱骨近端锁定加压接骨板进行内固定。观察两组患者的肩关节活动度和肩关节功能。结果两组患者的肩关节活动度中,外展外旋功能置换组均较固定组要好,差异有统计学意义(P<0.05);两组患者的前屈差异则无统计学意义(P>0.05)。肩关节功能当中,置换组患者效果优于固定组患者,差异有统计学意义(P<0.05);而清洗对策腋窝和拿重物指标当中,两组差异无统计学意义(P>0.05)。结论对于患者活动能力方面,人工肱骨头置换术的疗效要优于锁定钢板手术患者,能提高患者的生活自理能力和活动能力,对今后患者的生活较好,可对两种手术疗效的比较提供一个新的思路与角度。

Analysis of Locking Plate and Humeral Head Replacement in the Treatment of Proximal Humerus Comminuted Fractures

Objective To observe the clinical curative effect of locking plate and humeral head replacement in the treatment of proximal humerus comminuted fractures. Methods 30 patients with proximal humerus comminuted fractures in our hospital from July 2007 to December 2010 were randomly divided into two groups. The replacement group received the humeral head replacement, and the fixed group received the locking proximal humeral plate for internal fixation. The shoulder activity degree and shoulder joint function of two groups were observed. Results ①Shoulder activity degree: The abduction and lateral rotation of the shoulder in the replacement group were better than those in the fixed group, and the differences were statistically significant (P <0.05); There was no statistical difference in the anteflexion between two groups (P >0.05). ② Shoulder joint function: The curative effect in the replacement group were better than the fixed group, and the difference wasstatistically significant (P <0.05); There were no statistical differences in Cleaning the contralateral armpit and taking the weight index between two groups (P >0.05). Conclusions For patients’ activity ability, humeral head replacement has better curative effect than locking plate, which can improve the patients’ self-care ability and performance.