CAJ | 학술논문

目的：探讨人工肱骨头置换和钢板内固定在治疗复杂性肱骨近端骨折中的临床疗效。方法将2010年12月至2015年3月我院骨科收治的126例复杂性肱骨近端骨折患者按照治疗方法分为观察组和治疗组，观察组63例患者采取人工肱骨头置换治疗，对照组63例患者采用钢板内固定治疗，治疗后采用肩关节功能评估Neer评分系统进行评估、比较，治疗后随访3～6个月并比较两组患者的术后恢复和并发症发生情况。结果治疗前两组患者的病情程度等一般情况差异不显著，治疗后观察组患者临床疗效的总有效率高于对照组（P＜0．05），其肩关节疼痛评分、功能使用情况评分、活动范围评分和解剖评分均显著高于对照组（P＜0．05）；随访3～6个月后观察组患者术后恢复情况明显好于对照组（P＜0．05），其并发症的发生情况也较对照组少。结论人工肱骨头置换治疗复杂性肱骨近端骨折较钢板内固定治疗具有肩关节功能恢复快、活动范围大、解剖评分高、安全性高、并发症发生少等优点，值得在临床上推广应用。
목적：탐토인공굉골두치환화강판내고정재치료복잡성굉골근단골절중적림상료효。방법장2010년12월지2015년3월아원골과수치적126례복잡성굉골근단골절환자안조치료방법분위관찰조화치료조，관찰조63례환자채취인공굉골두치환치료，대조조63례환자채용강판내고정치료，치료후채용견관절공능평고Neer평분계통진행평고、비교，치료후수방3～6개월병비교량조환자적술후회복화병발증발생정황。결과치료전량조환자적병정정도등일반정황차이불현저，치료후관찰조환자림상료효적총유효솔고우대조조（P＜0．05），기견관절동통평분、공능사용정황평분、활동범위평분화해부평분균현저고우대조조（P＜0．05）；수방3～6개월후관찰조환자술후회복정황명현호우대조조（P＜0．05），기병발증적발생정황야교대조조소。결론인공굉골두치환치료복잡성굉골근단골절교강판내고정치료구유견관절공능회복쾌、활동범위대、해부평분고、안전성고、병발증발생소등우점，치득재림상상추엄응용。
Objective To study the clinical curative effect of artificial humerus head replacement and steel plate internal fixation for the treatment of complex proximal humerus fractures . Methods Between December 2010 and March 2015, 126 cases of patients admitted in orthopaedic department of our hospital with complex proximal humerus fractures were divided into observation group and treatment group according to treatment method .63 patients in the observation group were treated with artificial humerus head replacement , the other 63 cases in control group were treated by internal fixation with steel plate , after treatment the shoulder joint function appraisal Neer scoring system was used to assess the efficacy .After been followed-up for 3 to 6 months, postoperative recovery and complications of the two groups were compared .Results The degree of the condition of two groups before treatment had no significant difference in general , the total effective rate of observation group was higher than control group (P<0.05), the score of usage of the shoulder joint function , range score and the anatomy scores of the observation group were significantly higher than that of control group , however , shoulder joint pain score lower than the control group (P<0.05).Followed up for 3 to 6 months, postoperative recovery of observation group was much better than the control group ( P <0.05), the occurrence of complications was relatively less than control .Conclusions Artificial humerus head replacement for the treatment complex proximal fractures has the advantages including fast shoulder joint function recovery , wider range of activities , anatomical high grade , high safety and low complications compared with steel plate internal fixation treatment , worthy of popularization and application in clinic .