CAJ | 학술논문

目的：探讨肱骨近端解剖钢板与肱骨近端解剖锁定钢板治疗老年肱骨近端 Neer三、四部分骨折的功能及疗效差异。方法收集有完整随访资料的151例老年Neer 三、四部分骨折患者，按手术方式分为肱骨近端解剖钢板组（A 组，65例）和肱骨近端解剖锁定钢板组（B 组，86例），在随访过程采用Constant 评分及Neer 评分评价并比较两组疗效。结果 B 组平均愈合时间显著短于A 组（P＜0．05）。两组的术后1年和术后2年功能比较：B 组Neer 评分的疼痛、功能、活动度及总分均显著优于 A 组（P＜0．05）；B 组 Constant 评分的疼痛、日常生活活动、主动活动及总分显著优于 A 组（P＜0．05）。结论肱骨近端解剖钢板与肱骨近端解剖锁定钢板均可用于老年Neer 三、四部分骨折，但解剖锁定钢板愈合更快，功能恢复更好，临床推荐优先使用。
목적：탐토굉골근단해부강판여굉골근단해부쇄정강판치료노년굉골근단 Neer삼、사부분골절적공능급료효차이。방법수집유완정수방자료적151례노년Neer 삼、사부분골절환자，안수술방식분위굉골근단해부강판조（A 조，65례）화굉골근단해부쇄정강판조（B 조，86례），재수방과정채용Constant 평분급Neer 평분평개병비교량조료효。결과 B 조평균유합시간현저단우A 조（P＜0．05）。량조적술후1년화술후2년공능비교：B 조Neer 평분적동통、공능、활동도급총분균현저우우 A 조（P＜0．05）；B 조 Constant 평분적동통、일상생활활동、주동활동급총분현저우우 A 조（P＜0．05）。결론굉골근단해부강판여굉골근단해부쇄정강판균가용우노년Neer 삼、사부분골절，단해부쇄정강판유합경쾌，공능회복경호，림상추천우선사용。
Objective To investigate the effect of proximal humerus locking plate and proximal humerus anatomical plate on complex 3- and 4-part fractures of the proximal humerus (Neer classification) in the elders. Methods 151 cases of proximal humeral fractures were included in the study and divided into proximal humerus anatomical plate group (A group, n=65 cases) and proximal humerus locking plate group (B group, n=86 cases) according to different operation methods. The patients of A group underwent fracture fixation by anatomical plate and those in B group received fracture fixation by locking proximal humerus plate. The treatment effect was evaluated in two groups and compared between two groups by Neer score and Constant score. Results The mean humerus healing time of B group was significant superior to A group (P<0.05). Neer score, constant score, pain , function , activity and total score of shoulder in B group were significant superior to those in A group in 1 year and 2 years after operation (P<0.05). Conclusion Proximal humerus locking plate and proximal humerus anatomical plate could be used for three-and four-part of proximal humeral fractures in the elders , but proximal humerus locking plate has andvantage for humerus healing time , functional rehabilitation.