【摘要】 目的 探究与肱骨近端骨折术后功能结局相关的X线参数。方法 回顾性纳入2022年1月至2024年12月于本院就诊的肱骨近端骨折行钢板内固定手术患者82例，术后3月进行Constant评分，依据Constant评分分为优/良组和中/差组。基于术后1年肩关节X线正位，测量肱骨外侧偏移、肱骨头直径、肱骨头高度以及颈干角和肱骨头干角等放射学参数，比较同一患者手术侧和非手术侧，及不同Constant评分患者放射学参数的差异。结果 手术侧颈干角（123.1°±12.9°vs. 130.1°±7.3°，P=0.009）以及头干角（33.1°±12.8°vs. 40.1°±7.3°，P<0.001）均显著小于非手术侧，其余参数差异无统计学意义（P>0.05）。所有患者平均Constant评分为（80.2±17.4）分，其中优/良组65例，中/差组17例。对不同Constant评分分组患者比较发现，与评分中/差组相比，评分优/良组患者肱骨外侧偏移（49.20±5.00 mm vs. 45.36±3.35 mm,P=0.004）、肱骨头直径（48.56±4.69 mm vs. 45.42±3.87 mm,P=0.013）和肱骨头高度（20.81±2.56 mm vs. 18.67±2.11 mm,P=0.002）、颈干角（125.40°±11.97°vs. 114.10°±13.09°，P=0.001）和头干角（35.3°5±11.98°vs. 24.26°±13.23°，P=0.001）更大。结论 肱骨近端骨折患者若术后存在较小的肱骨外侧偏移、肱骨头直径和高度，以及较小的颈干角和头干角角度，其术后功能恢复可能相对较差。更多还原

【Abstract】 Objective To investigate X-ray parameters related to postoperative functional outcomes of proximal humerus fractures. Methods This retrospective study included 82 patients with proximal humerus fractures treated with plate osteosynthesis admitted to our hospital from January2022 to December 2024. Constant scores were measured at 3 months postoperative, and patients were categorized into excellent/good and fair/poor groups accordingly. Radiological parameters, including lateral displacement of the humerus, humeral head diameter, height, neck-shaft angle, and head-shaft angle were measured on shoulder anteroposterior X-rays at 1 year post-surgery. Comparisons were made between surgical and non-surgical sides in the same patient, as well as between different Constant score groups. Results The surgical side showed significantly smaller neck-shaft angles(123.1°±12.9° vs. 130.1°±7.3°, P=0.009) and head-shaft angles(33.1°±12.8° vs. 40.1°±7.3°, P<0.001) than the non-surgical side, with no significant differences in other parameters(P>0.05). The average Constant score for all patients was 80.2 ±17.4, with 65 in the excellent/good group and17 in the fair/poor group. Comparisons between Constant score groups revealed that the excellent/good group had significantly greater lateral displacement(49.20±5.00mm vs. 45.36±3.35mm, P=0.004), humeral head diameter(48.56 ±4.69 mm vs. 45.42±3.87 mm, P=0.013), height(20.81 ±2.56 mm vs. 18.67±2.11 mm, P=0.002), neck-shaft angle(125.40°±11.97° vs. 114.10°±13.09°, P=0.001), and head-shaft angle(35.35±11.98 vs. 24.26±13.23,P=0.001) than the fair/poor group. Conclusion Proximal humerus fracture patients with smaller lateral displacement, humeral head diameter and height, as well as smaller neck-shaft and head-shaft angles postoperatively may have relatively poorer functional recovery.更多还原