PHILOS钢板与髓内钉治疗肱骨近端骨折的疗效比较

目的比较PHILOS钢板和髓内钉治疗NeerⅡ、Ⅲ型肱骨近端骨折的疗效。方法回顾性分析PHILOS钢板和髓内钉治疗NeerⅡ、Ⅲ型肱骨近端骨折的临床效果。2012年9月—2016年10月余姚市中医医院共手术治疗NeerⅡ、Ⅲ型肱骨近端骨折70例。其中37例采用PHILOS钢板内固定手术治疗,平均随访时间为14.5个月(6~30个月),33例采用髓内钉内固定手术治疗,平均随访时间为13.1个月(7~21个月),比较两组手术时间及出血量、并发症例数及术后Constant-Murley肩关节功能评分。结果髓内钉组在手术时间及出血量(50.2±9.8)min、(150.0±20.4)m L]方面均较PHILOS钢板组(70.9±10.5)min、(300.0±30.6)m L]有优势,两组比较差异有统计学意义(P0.05),而Constant-Murley肩关节功能评分和并发症例数方面,两组差异无统计学意义(P0.05)。结论 PHILOS钢板和髓内钉组在术后功能恢复及并发症例数方面无差异,均能取得良好的疗效,后者在术中出血量及手术时间方面具有优势。

Efficacy comparison of PHILOS plate and intramedullary nail in the treatment of proximal humeral fractures

Objective To analyze the clinical effect of PHILOS plate and intramedullary nail in the treat-ment of proximal humeral fractures of Neer type Ⅱ and Ⅲ.Methods The clinical results of 70 patients with proximal humeral fractures of Neer type ⅡandⅢwere retrospective analyzed,who were treated in our hospital from Sep.2012 to Oct.2016.Thirty-seven cases were treated with PHILOS plate internal fixation,and the average fol-low-up time was 14.5 months(6-30 months);33 cases were treated with intramedullary nail fixation,and the aver-age follow-up time was 13.1 months(7-21months).The operation time,blood loss,Constant-Murley score of the function in the shoulder joint and postoperative complications were compared between the two groups.Result The operation time and blood loss of the intramedullary nail group were(50.2 ±9.8)min,(150.0 ±20.4)mL,respec-tively,which were better than those of the PHILOS plate group((70.9 ±10.5)min,(300.0 ±30.6)mL),with sig-nificant differences between two groups(P<0.05).No significant difference was observed in the Constant-Murley score of the shoulder joint function and the number of patients with complications(P>0.05).Conclusion There is no difference in postoperative recovery of function and complications between the PHILOS plate group and the intr -amedullary nail group,which can achieve good results,but the latter has advantages in blood loss and operation time.