【摘要】 目的 比較非手術(shù)治療與鎖定鋼板內(nèi)固定治療老年肱骨近端NeerⅢ、Ⅳ型骨折的療效差異。方法 70例老年肱骨近端NeerⅢ、Ⅳ型骨折患者， 按隨機(jī)數(shù)字表法分為保守組和手術(shù)組， 每組35例。保守組患者行手法復(fù)位小夾板外固定治療， 手術(shù)組患者行鎖定鋼板內(nèi)固定治療。比較兩組的治療效果。結(jié)果 兩組骨折愈合時間比較差異無統(tǒng)計學(xué)意義（P>0.05）;手術(shù)組住院時間（12.20±0.65）d長于保守組的（7.60±0.60）d， 并發(fā)癥發(fā)生率14.29%低于保守組的51.43%， 差異均具有統(tǒng)計學(xué)意義（P<0.05）。治療
　　6個月后手術(shù)組的優(yōu)良率與保守組比較差異無統(tǒng)計學(xué)意義（P>0.05）。治療6個月后手術(shù)組Constant-Murley功能評分中疼痛、日常活動、活動度、肌力評分與保守組比較差異均無統(tǒng)計學(xué)意義（P>0.05）。
　　結(jié)論 鎖定鋼板內(nèi)固定治療老年肱骨近端NeerⅢ、Ⅳ型骨折固定可靠， 利于早期功能鍛煉， 但存在一定風(fēng)險， 而保守治療治療費(fèi)用低， 且肩關(guān)節(jié)功能改善效果與手術(shù)治療相當(dāng)， 醫(yī)生應(yīng)根據(jù)患者實際情況進(jìn)行合理選擇。
　　【關(guān)鍵詞】 肱骨近端NeerⅢ、Ⅳ型骨折;鎖定鋼板內(nèi)固定;保守治療;肩關(guān)節(jié)功能;老年
　　DOI：10.14163/j.cnki.11-5547/r.2018.12.013
　　【Abstract】 Objective To compare the efficacy difference of non-operative therapy and locking plate internal fixation in the treatment of Neer Ⅲ and Ⅳ type proximal humerus fractures in the elderly. Methods A total of 70 elderly patients with Neer Ⅲ and Ⅳ type proximal humerus fractures were divided by random number table method into conservative group and operative group， with 35 cases in each group. The conservative group received manual reduction and small splint external fixation therapy， and the operative group received locking plate internal fixation. The treatment effect in two groups was compared between the two groups. Results Both groups had no statistically significant difference in fracture healing time （P>0.05）. The operative group had longer hospitalization time as （12.20±0.65） d than （7.60±0.60） d in conservative group， and lower incidence of adverse reactions as 14.29% than 51.43% in the conservative group. Their difference was statistically significant （P<0.05）. After 6 months of treatment， the operative group had no statistically significant difference in excellent rate comparing with conservative group （P>0.05）. After 6 months of treatment， the operative group had no statistically significant difference in Constant-Murley function score of pain， daily activity， activity and muscle strength （P>0.05）. Conclusion Locking plate internal fixation for the treatment of Neer Ⅲ and Ⅳ type proximal humerus fractures is reliable and is conducive to early functional exercise， but there is a certain risk. While the cost of conservative treatment is low， and the effect of shoulder joint function improvement is equal to that of operative therapy. The doctor should make reasonable choice according to the actual situation of the patients.
　　【Key words】 NeerⅢ and Ⅳ type proximal humerus fractures; Locking plate internal fixation; Conservative therapy; Shoulder joint function; Elderly

相關(guān)熱詞搜索：肱骨 治療 鋼板 骨折 療效