于海军辽宁省东港市中医院骨科，辽宁东港　118300

带锁髓内钉与锁定钢板治疗老年肱骨近端骨折的临床疗效对比分析

于海军
辽宁省东港市中医院骨科，辽宁东港118300

目的比较分析带锁髓内钉与锁定钢板治疗老年肱骨近端骨折的临床疗效。方法收集2014年3月～2015年1月期间我院就诊的老年肱骨近端骨折患者92例，将患者按照随机数字表法分为两组，A组和B组，每组46例，A组采用带锁髓内钉治疗，B组采用锁定钢板治疗，比较两组患者肩关节功能优良率、术中情况、骨折愈合时间及随访Constant-Mur1ey评分、并发症发生情况。结果A组切口长度为（3.1±0.4）cm，小于B组的（11.7±2.5）cm，出血量为（89.5±14.9）mL，少于B组的（145.3±21.8）mL，手术时间为（72.6±13.7）min，短于B组的（90.8±16.2）min，术后3个月、6个月Constant-Mur1ey评分为（78.5±12.8、81.8±13.6）分，明显高于B组的（71.3±11.5、78.2±12.9）分，两组差异有统计学意义（P＜0.05）；两组骨折愈合时间［（2.8±0.3）月vs（3.3±0.5）月］、肩关节功能优良率（93.48%vs 84.78%）、术后12个月两组Constant-Mur1ey评分（86.1±14.7 vs 84.9±14.1）、并发症发生率（21.74%vs 15.22%）比较，差异无统计学意义（P＞0.05）。结论带锁髓内钉与锁定钢板治疗老年肱骨近端骨折均可取得较好的效果，但带锁髓内钉治疗老年肱骨近端骨折患者优势更显著，如在条件允许的情况下，应将带锁髓内钉作为手术治疗老年肱骨近端骨折的首选方案。

肱骨骨折；带锁髓内钉；锁定钢板；内固定

［Abstract］Objective To compare the c1inica1 efficacy of the e1der1y patients with proxima1 humerus fractures treated with inter1ocking intramedu11ary nai1 and the 1ocking p1ate.Methods 92 patients of e1der1y proxima1 humerus fractures were se1ected from March 2014 to January 2015 in our hospita1，a11 of them were random1y divided into two groups，group A and group B，there were 46 cases in each group，group A used inter1ocking intramedu11ary nai1 treatment，group B used 1ocking p1ate treatment，the shou1der function exce11ent rate，intraoperative conditions，fracture hea1ing time and fo11ow-up Constant-Mur1ey score，comp1ications of two groups were compared.Results The incision 1ength of group A was（3.1±0.4）cm，1ess than（11.7±2.5）cm of group B，the 1ess b1ood 1oss was（89.5±14.9）mL，sma11er than （145.3±21.8）mL of group B，the operative time was（72.6±13.7）min，shorter than（90.8±16.2）min of group B，Constant-Mur1ey score after 3 months，6 months was（78.5±12.8，81.8±13.6）scores，significant1y higher than（71.3±11.5，78.2± 12.9）scores of group B，the difference was statistica11y significant（P＜0.05）；Compared with group B，the fracture hea1ing time［（2.8±0.3）months vs（3.3±0.5）months］，shou1der function good rate（93.48%vs 84.78%），Constant-Mur1ey scores after 12 months（86.1±14.7 vs 84.9±14.1），the comp1ication rate（21.74%vs 15.22%）of group A were no significant differences（P＞0.05）.Conclusion The effect of e1der1y patients with proxima1 humerus fractures treated with inter1ocking intramedu11ary nai1 or 1ocking p1ate can is good，but the advantages of the inter1ocking intramedu11ary nai1 is more significant，we shou1d accept the inter1ocking intramedu11ary nai1 surgery as the preferred so1ution e1der1y proxima1 humerus fractures as under conditions permitting.

［Key words］Fractures；Inter1ocking intramedu11ary nai1；Locking p1ate；Fixation

肱骨近端骨折是临床常见的一种骨折类型，中老年发生率较高，近年来，随着交通业的快速发展，肱骨近端骨折的发生率呈现逐年升高的趋势。患者有剧烈的疼痛感，会对正常的生活和工作造成严重影响，病情严重的患者预后较差［1］。肱骨近端……