两种手术方式治疗老年肱骨近端Neer四部分骨折的疗效比较

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Abstract Objective To compare the efficacy of locking compression plate (LCP) and half shoulder replacement (HSR) in the treatment of elderly proximal humeral Neer four-part fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 37 elderly patients with Neer four-part fractures of the proximal humerus who were admitted to General Hospital of North China Msedical & Health Group Xingtai from November 2017 to November 2019.14 males and 23 females were included.The patients’ age ranged from 62 to 73 years (68.5±5.5 years).20 cases underwent open reduction and LCP internal fixation (LCP group)，and 17 cases underwent HSR (HSR group).The incision length，operation time，intraoperative blood loss，postoperative complication rate，and Neer score and visual analog scale(VAS) of shoulder joint function at 1，3，6 and 12 months after operation were compared between the two groups.Results All patients were followed up for 12~22 months (16.5±4.5 months).The operation time and the amount of intraoperative blood loss in the LCP group were less than those in the HSR group (P＜0.01)，The incision length of the two groups was not statistically significant (P＞0.05).The Neer scores of the shoulder joint in the HSR group were better than those in the LCP group at 1 month and 3 months after operation (P＜0.01) There was no significant difference between the two groups at 6 months after surgery (P＞0.05) But at 12 months after surgery，the Neer score of the shoulder joint in the LCP group was better than the HSR group (P＜0.01).The curative effect at 12 months after operation was evaluated by Neer scoring standard.In the LCP group，6 cases were excellent，10 cases were good，2 cases were fair，and 2 cases were poor.In the HSR group，2 cases were excellent，6 cases were good，5 cases were fair，and 4 cases were poor (P＜0.01).The VAS in the HSR group were better than the LCP group at 1 month and 3 months after operation (P＜0.01).There was no statistically significant difference between the two groups at 6 months after surgery (P＞0.05)，but the VAS of the LCP group was better than the HSR group after 12 months after surgery(P＜0.01).Conclusion For elderly Neer four-part fractures of the proximal humerus，open reduction and LCP internal fixation have a shorter operation time and less intraoperative blood loss than HSR.The long-term function recovery of the affected limb is better and the pain relief is more obvious.

Key words： humeral fractures internal fixation of fracture half shoulder replacement

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	You Xiaojun
	Zhang Yu
	Ji Jinwei
	Liu Haibo
	Zhang Peipei
	He Juren

Cite this article:

You Xiaojun,Zhang Yu,Ji Jinwei, et al. Comparison of the Effect of Two Surgical Methods in the Treatment of Senile Proximal Humeral Neer Four-Part Fractures[J]. sygkzz, 2022, 28(7): 590-595.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I7/590

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