蔡俊雄

[摘要] 目的 分析鎖定钢板在复杂肱骨近端骨折治疗中的临床效果。方法 方便选取2014年1月—2017年12月在该院就诊的复杂肱骨近端骨折患者56例，依照数字随机表法将其分成对照组及观察组，每组28例，对照组予以LPHP方案治疗，观察组予以PHILOS治疗，分析组间治疗效果差异。结果 观察组术中出血量（40.85±32.84）mL及骨折愈合时间（12.67±2.52）d均显著低于对照组的（71.56±6.90）mL、（18.76±3.34）d，组间数据差异有统计学意义（t=20.579、7.702，P<0.05）;观察组术后6个月肩关节外旋、前屈、外展及内旋活动度分别为（44.52±3.51）°、（115.87±5.69）°、（128.57±4.58）°、（45.95±4.42）°显著高于对照组的（41.08±3.17）°、（103.84±4.88）°、（121.46±4.29）°、（41.81±4.05）°，组间数据差异有统计学意义（t=5.669、8.492、5.995、3.654，P<0.05）;观察组术后12个ASES、VAS、UCLA及SST评分分别为（78.84±5.57）分、（1.01±0.49）分、（31.51±1.68）分、（8.19±1.04）分，与对照组的（77.49±4.91）分、（1.22±0.52）分、（30.94±1.73）分、（7.79±0.95）分之间数据差异无统计学意义（t=0.962、1.555、1.251、1.503，P>0.05）;观察组术后6个月切口感染率3.57%、切口延迟愈合率0.00%、钢板松动率0.00%、肩关节僵硬率0.00%均稍低于对照组的7.14%、3.57%、7.14%、3.57%（χ2=0.352、1.018、2.074、1.018，P>0.05）。结论 在复杂肱骨近端骨折切开复位内固定术中予以锁定钢板有助于加速患者康复，临床价值较好。

[关键词] 锁定钢板;复杂巩固近端骨折;治疗效果

[中图分类号] R687          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0038-03

Clinical Effect of Locking Plate in the Treatment of Complex Proximal Humerus Fracture

CAI Jun-xiong

Department of Orthopaedics， Yong'an Municipal Hospital， Sanming， Fujian Province， 366000 China

[Abstract] Objective To analyze the clinical effect of locking plate in the treatment of complex proximal humeral fractures. Methods A total of 56 patients with complicated proximal humeral fractures who were Convenient treated in our hospital from January 2014 to December 2017 were enrolled. The patients were divided into the control group and the observation group according to the numerical random table method. Each group had 28 cases， and the control group was given LPHP. In the treatment of the regimen， the observation group was treated with PHILOS， and the difference in treatment effect between the groups was analyzed. Results The intraoperative blood loss （40.85±32.84）mL and fracture healing time （12.67±2.52）d were significantly lower in the observation group than in the control group （71.56±6.90）mL， （18.76±3.34）d. Statistical significance （t=20.579， 7.702， P<0.05）; the external rotation， flexion， abduction and internal rotation of the shoulder joint in the observation group were （44.52±3.51）°， （115.87±5.69）， （128.57±4.58）°， （45.95±4.42）° significantly higher than the control group （41.08 ± 3.17）°，（103.84 ± 4.88）°，（121.46 ± 4.29）°，（41.81±4.05）°， there were statistically significant differences between the groups （t=5.669， 8.492， 5.995， 3.654， P<0.05）. The scores of 12 ASES， VAS， UCLA and SST in the observation group were （78.84±5.57） points and （1.01±0.49）points，（31.51±1.68） points，（8.19±1.04）points， and （77.49±4.91）points， （1.22±0.52）points， （30.94±1.73）points， and （7.79±0.95）points of the control group. There was no significant difference between the data（t=0.962， 1.555， 1.251， 1.503， P>0.05）; the incision infection rate was 3.57% in the observation group at 6 months after operation， and the incision delayed healing rate of 0.00%， 0.00% loosing， shoulder stiffness were slightly lower than 0.00% and 7.14%， 3.57%， 7.14%， 3.57% in the control group （χ2=0.352，1.018，2.074，1.018， P>0.05）. Conclusion Locking the plate in the open reduction and internal fixation of the proximal humerus fracture is helpful to accelerate the recovery of the patient and has a good clinical value.

[Key words] Locking plate; Complex consolidation of proximal fracture; Treatment effect

复杂肱骨近端骨折在任意年龄均可发作，但以老年人群多见，这与老年人群骨质疏松风险较高有关，而且其发病率呈逐渐上升趋势[1]，现多利用切开内固定术等手术治疗。该次研究以2014年1月—2017年12月期间，该院就诊的复杂肱骨近端骨折患者56例为研究对象，均采取切开复位内固定术进行治疗，分析术中应用常规钢板、锁定钢板的治疗效果差异，现报道如下。

1  资料与方法

1.1  一般资料

该次研究方便择取入该院治疗的复杂性肱骨骨折患者56例，按照数字随机表法将其分成对照组（n=28）及观察者（n=28）。对照组，男11例，女17例，年龄20～76岁，年龄平均（56.07±8.95）岁;车祸致伤4例，摔跌致伤24例;NEER 3、4部分骨折分别25例、3例。观察组，男12例，女16例，年龄22～77岁，年龄平均（57.61±8.74）岁;车祸致伤2例，摔跌致伤26例;NEER 3、4部分骨折分别24例、4例。比较……