手术与非手术治疗老年肱骨近端骨折的疗效对比研究

目的比较手术与非手术治疗老年肱骨近端骨折的治疗效果。方法 46例老年肱骨近端骨折患者按照治疗方法分为手术组(28例)与非手术组(18例),分别接受手术切开复位锁定钢板内固定治疗及外固定支架固定治疗,比较两组患者术后治疗效果。结果两组患者年龄、性别比及Neer分型无显著差异(P>0.05)。手术组NeerⅡ型骨折的优良率(88.24%)与非手术组(80.00%)比较差异无统计学意义(P>0.05),但手术组NeerⅢ型骨折的优良率(90.91%)显著高于非手术组(37.50%),差异有统计学意义(P<0.01)。结论老年肱骨近端骨折患者预后与骨折严重程度有关,NeerⅡ型骨折尽量采用非手术治疗,但NeerⅢ型骨折应采用手术治疗。

Comparative Study of the Therapeutic Effect between Surgical and Non-surgical Treatment for Proximal Humeral Fracture in Elderly Patients

Objective To compare the therapeutic effect between surgical and non-surgical treatment for proximal humeral fracture in elderly patients. Methods A total of 46 elderly patients with proximal humeral fracture were divided into surgical group （n=28, received internal fixation with proximal humeral anatomic plate） and non-surgical group （n=18, received external fixation） , the therapeutic effect between the two groups was compared. Results No statistical difference in age, gender and Neer types between the two groups were observed （P〉 0.05 ） . The good rate of Neer Ⅱ type fracture in surgical group （88.24%） showed no statistical difference with non-surgical group （80.00%） （P〉0.05） , but the good rate of NeerⅢ type fracture of surgical group （90.91%） was significantly higher than that of non-surgical group （37.50%） （P〈0.01） . Conclusion The prognosis of proximal humeral fracture in elderly patients is related to the severity of fracture, patients with Neer Ⅱ type fracture should receive non-surgical treatment, and patients with Neer Ⅲ type fracture should receive surgical treatment.