CAJ | 학술논문

目的：对比分析锁定加压钢板与解剖型钢板内固定治疗肱骨近端骨折的临床效果，探讨合适的肱骨近端骨折内固定方法。方法对2007年1月至2013年1月苏州市第七人民医院收治的63例肱骨近端骨折患者的临床资料进行回顾性分析，其中31例采用锁定加压钢板固定，32例行解剖型钢板固定。观察术后并发症发生情况，根据Neer评分标准对疗效进行评定。结果锁定加压钢板组25例患者获得有效随访，随访时间6～36个月，平均随访时间16个月；解剖型钢板组29例患者获得有效随访，随访时间7～48个月，平均随访时间26个月。锁定加压钢板组术后肩关节功能Neer评分优良率优于解剖型钢板组，但两组比较，差异无统计学意义（96% vs 90%，P＞0.05）。解剖型钢板组1例患者发生肱骨头坏死、吸收，2例出现螺钉松动、部分拔出。两组均未出现断钉、再骨折移位、骨折不愈合、桡神经损伤、腋神经损伤等术后并发症。结论锁定加压钢板和解剖型钢板内固定均能有效治疗肱骨近端骨折，但锁定加压钢板内固定并发症少，更加安全可靠。
목적：대비분석쇄정가압강판여해부형강판내고정치료굉골근단골절적림상효과，탐토합괄적굉골근단골절내고정방법。방법대2007년1월지2013년1월소주시제칠인민의원수치적63례굉골근단골절환자적림상자료진행회고성분석，기중31례채용쇄정가압강판고정，32례행해부형강판고정。관찰술후병발증발생정황，근거Neer평분표준대료효진행평정。결과쇄정가압강판조25례환자획득유효수방，수방시간6～36개월，평균수방시간16개월；해부형강판조29례환자획득유효수방，수방시간7～48개월，평균수방시간26개월。쇄정가압강판조술후견관절공능Neer평분우량솔우우해부형강판조，단량조비교，차이무통계학의의（96% vs 90%，P＞0.05）。해부형강판조1례환자발생굉골두배사、흡수，2례출현라정송동、부분발출。량조균미출현단정、재골절이위、골절불유합、뇨신경손상、액신경손상등술후병발증。결론쇄정가압강판화해부형강판내고정균능유효치료굉골근단골절，단쇄정가압강판내고정병발증소，경가안전가고。
Objective To compare clinical results between locking compression plate (LCP) and anatomical plate (ACP) internal fixation in the treatment of proximal humeral fracture, and to explore the appropriate internal fixation methods for the fracture. Methods From January 2007 to January 2013, 63 patients with proximal humeral fracture were treated by LCP or ACP fixation in the Seventh People's Hospital of Suzhou, among them 26 patients underwent LCP fixation (LCP group), while 37 patients underwent ACP fixation (ACP group). Postoperative complications were observed, and clinical effects were evaluated by Neer scoring standard. Results In LCP group, 25 patients were followed up for an averge of 16 months (6-36 months); In ACP group, 29 patients were followed up for an averge of 26 months (7-48 months). According to Neer scoring criteria, good-excellent rate in LCP group was better than that in ACP group, but there had no statistical differences between two groups (96% vs 90%, P >0.05). During the follow-up, there were humeral head necrosis and absorption in 1 case and screw loosening and partly pull-out in 2 cases in ACP group. No poseoperative complications such as screw breakage, refracture, displacement, bone nonunion, radial or axillary nerve injury had been obseved in 2 groups. Conclusion Both LCP and ACP fixation are effective for patients with proximal humeral fracture, but LCP treatment in this study shows less postoperative complications and obtain more safe and reliable effects.