【摘要】 目的探讨半肩关节置换与肱骨近端内固定锁定系统(philos)治疗对肱骨近端粉碎性骨折的治疗效果。方法我院就诊的老年肱骨近端粉碎性骨折患者146例。其中73例采用philos钢板内固定治疗纳入内固定组,73例采用半肩关节置换治疗纳入关节置换组。比较两组围术期指标、术后3、6个月时的疼痛情况、肩关节活动度及肩功能恢复状况;比较术后并发症发生率。结果关节置换组的围术期指标均少于内固定组,术后3、6个月的VAS评分低于内固定组,关节活动度高于内固定组(P<0.05)。关节置换组术后3个月Constant-Murley总分高于内固定组(P<0.05),但两组术后6个月比较差异无统计学意义(P>0.05);两组术后并发症比较差异无统计学意义(P>0.05)。结论与philos钢板内固定术相较,半肩关节置换术可有效缩短老年肱骨近端粉碎性骨折患者的手术时间,减少出血量及缓解术后疼痛。更多还原

【Abstract】 Objective To explore the treatment effect of shoulder hemiarthroplasty and proximal humeral internal locking sys-tem(Philos) in the treatment of elderly comminuted proximal humeral fractures.Methods One hundred and forty-sixelderly patients with comminuted proximal humeral fractures treated in our hospital were retrospectively analyzed.Among the patients,73 patients weretreated with Philos plate internal fixation(internal fixation group) and 73 patients were treated with shoulder hemiarthroplasty(arthro-plasty group).Theperioperative indicators,pain,the shoulder range of motion and theshoulder function recovery after 3 and 6 months ofsurgery andthe occurrence of postoperative complications were compared between the two groups.Results The perioperative indicatorsof the arthroplasty group were significantly less than those of the internal fixation group(P<0. 05).The VAS scores after 3 and 6 monthsof surgery were significantly decreased and the joint range of motionwassignificantly improved in the arthroplasty group when comparedto the internal fixation group(P<0. 05).The Constant-Murley total score after 3 months of surgery in the arthroplasty group was higherthan that in the internal fixation group(P<0. 05),but there was no significant difference in the score after 6 months of surgery betweenthe two groups(P>0. 05).There were no statistical differences in postoperative complications between the two groups(P>0. 05).Conclusion Shoulder hemiarthroplasty is more effective in shortening the surgical time,reducing the blood loss,and alleviating the postop-erative pain of the elderly patients when compared to Philos plate internal fixation.更多还原