老年骨质疏松性肱骨近端骨折手术与非手术治疗的临床对照研究

目的：比较手术和非手术方法治疗老年骨质疏松性肱骨近端骨折的临床疗效。方法：回顾性分析2006年1月～2010年12月我院收治的157例老年骨质疏松性肱骨近端骨折患者，其中手术组（88例）给予切开复位内固定治疗，非手术组（69例）给予闭合复位外固定治疗。采用Neer评分标准评价治疗后效果。结果：根据Neer标准，手术组总优良率为92．0％，非手术组总优良率为79．7％，两组总优良率比较。差异有高度统计学意义（P〈0．01）。结论：老年骨质疏松性肱骨近端骨折预后情况与创伤的严重程度有关，所以应根据骨折分型采取不同的治疗方法．如对Neer分型中I型和Ⅱ型部分患者应采用非手术方法治疗。Ⅲ、Ⅳ型应采用手术方法治疗。

Comparison of the curative effect between surgical and non-surgical treatment for senile osteoporotic proximal humeral fractures

Objective： To compare the curative effect between surgical and non-surgical treatment for senile osteoporotic proximal humeral fractures. Methods： From January 2006 to December 2010,157 senile patients with osteoporotic proximal humerus fracture were randomly divided into two groups to receive different treatments. Surgical group （88 cases） were treated with internal fixation, while non-surgical group （69 cases） with closed reduction. The curative effect was evaluated according to Neer＇s Score. Results： According to Neer＇s Score, the overall excellent and good rate in surgical group （92.0%） was higher than that in non-surgical group （79.7%）. There was a statistically significant difference between surgical and non-surgical group （P〈0.01）. Conclusion： The prognosis of senile osteoporotic proximal humeral fractures is closely related to fracture type, so the treatment should be selected according to fracture type, such as, Neer types I and II of proximal humeral fracture should be treated with non-surgical treatment, Neer types III and IV should be treated with surgical treatment.