CAJ | 학술논문

目的：对比锁定钢板与人工肱骨头置换治疗老年肱骨近端三部分骨折的临床疗效。方法：34例老年肱骨近端3部分骨折患者，19例行切开复位锁定钢板内固定术；15例行人工肱骨头置换。对2组手术时间、术中出血量、骨折愈合时间、并发症、肩关节功能和术后疼痛程度等进行随访对比观察。结果：2组平均手术时间、出血量差异有统计学意义（ P ＜0．05）；2组骨折愈合时间、最终随访肩关节功能Neer评分及疼痛视觉模拟评分（ visual analog scale，VAS）、术后优良率、术后并发症发生率差异无统计学意义（P ＞0．05）。结论：人工肱骨头置换与锁定钢板治疗老年人肱骨近端三部分骨折均能达到满意的疗效，但人工肱骨头置换具有手术时间短，出血量少等优势，更适合于伴有严重骨质疏松的高龄老年患者，以及骨折严重粉碎无法重建的肱骨近端骨折。
목적：대비쇄정강판여인공굉골두치환치료노년굉골근단삼부분골절적림상료효。방법：34례노년굉골근단3부분골절환자，19례행절개복위쇄정강판내고정술；15례행인공굉골두치환。대2조수술시간、술중출혈량、골절유합시간、병발증、견관절공능화술후동통정도등진행수방대비관찰。결과：2조평균수술시간、출혈량차이유통계학의의（ P ＜0．05）；2조골절유합시간、최종수방견관절공능Neer평분급동통시각모의평분（ visual analog scale，VAS）、술후우량솔、술후병발증발생솔차이무통계학의의（P ＞0．05）。결론：인공굉골두치환여쇄정강판치료노년인굉골근단삼부분골절균능체도만의적료효，단인공굉골두치환구유수술시간단，출혈량소등우세，경괄합우반유엄중골질소송적고령노년환자，이급골절엄중분쇄무법중건적굉골근단골절。
Objecit ve:To comparative study of clinical efficacy of locked plate and artificial humeral head replacement for treating eld-erly patientsˊproximal humeral Neer three-part fractures.M ethods:among 34 elderly patients with proximal humeral Neer three-part fractures 19 cases received open reduction locked compressive plates and 15 cases received artificial humeral head replacement.Operation time,intraoperative blood loss,fracture healing time, complications,shoulder joint function and the degree of postoperative pain between two groups were comparatively observed in follow-up.Results:mean operation time,blood loss between two groups were statistically sig-nificant(P <0.05);fracture healing time, neer score of shoulder joint function in final follow-up,VAS score of pain and postoperative excellent rate,postoperative complication rate between two groups were no statistically significant(P >0.05).Conlc usio n:artificial hu-meral head replacement and locked plate for treating elder patientsˊproximal humeral Neer three-part fractures could get satisfied curative effect,however,artificial humeral head replacement might have advantage of shot operation time,Less blood loss,which is more suitable for elderly patients with severe osteoporosis and severe crushing fracture of proximal humerus cannot be reconstructed.