【摘要】 目的:对比分析TRIGEN髓内钉与PHILOS钢板治疗Neer 2、3部分肱骨近端骨折(PHF)的临床疗效。方法:回顾分析2017年2月～2019年7月芜湖市第二人民医院骨科采用TRIGEN髓内钉与PHILOS钢板治疗的30例Neer 2、3部分PHF患者资料。根据内固定方式分两组,TRIGEN髓内钉组15例,PHILOS钢板组15例。所有患者均随访12个月以上。对比两组的手术时间、术中出血量、平均住院时间、末次Constant-Murley肩关节功能评分(CMS)及并发症发生情况。结果:TRIGEN髓内钉组手术时间[(72.13±1.77)min]、术中出血量[(56.00±7.54)mL]、住院时间[(11.93±0.46)d]均优于PHILOS钢板组[(102.70±4.02)min、(180.00±25.26)mL、(14.07±0.69)d],差异有统计学意义(P<0.05);而两组在末次CMS评分及并发症发生率上差异无统计学意义(P>0.05)。结论:对于Neer 2、3部分PHF,TRIGEN髓内钉与PHILOS钢板治疗均能取得满意疗效;TRIGEN髓内钉手术微创,能减少术中出血量,缩短手术时间及住院时间,符合加速康复外科理念,值得临床应用推广。更多还原

【Abstract】 Objective:To compare the clinical efficacies of TRIGEN nail and PHILOS plate in the treatment of proximal humerus fractures(PHF,2-part or 3-part fractures by Neer classification).Methods:Retrospective analysis was performed in 30 cases of PHF(2-part or 3-part fractures by Neer classification) treated with TRIGEN nail and PHILOS plate in our hospital between February 2017 and July 2019.The cases were divided into two groups according to the internal fixation(TRIGEN nail group,n=15;PHILOS plate group,n=15).All patients were followed up over 12 months,and compared regarding the operative time,intraoperative blood loss,average length of hospital stay,Constant-Murley scores and postoperative complications between the two groups.Results:The operative time,intraoperative blood loss and average length of hospital stay were(72.13±1.77)min,(56.00±7.54)mL and(11.93±0.46)d for TRIGEN nail group,and(102.70±4.02)min,(180.00±25.26)mL and(14.07±0.69)d for PHILOS plate group,respectively.The difference was significant(P<0.05),yet insignificant in Constant-Murley scores and incidence of complications between groups(P>0.05).Conclusion:Both of TRIGEN nail and PHILOS plate can achieve satisfactory efficacy in the treatment of PHF at 2-part or 3-part fractures by Neer classification,however,TRIGEN nail can be minimal invasion,reduced intraoperative blood loss,shortened operative time and length of hospital stay,which is worthy of wider clinical recommendation because of its compliance with practice of enhanced recovery after surgery(ERAS).更多还原