关键词:

肱骨近端骨折, Multiloc 髓内钉, Philos 钢板, 骨折切开复位内固定

Abstract:

Objective To compare the therapeutic effects between Mutiloc intramedullary nail and Philos plate in the treatment of Neer two⁃ or three⁃part proximal humerus fractures（PHF）. Methods Clinical data of 93 patients with Neer two⁃ or three⁃part PHF admittedin our hospital from January 2015 to June 2019 were analyzed retrospectively and were divided into Mutiloc intramedullary nail group（n = 30）and Philos plate group（n = 56） according to internal fixation procedures.The operation time，intraoperative estimate blood loss and postoperative complications were recorded，visual analogue scale（VAS）score，American Shoulder and Elbow Surgeons（ASES） score and Constant shoulder function score of the shoulder joint were used to evaluate the shoulder joint function at 12 weeks after operation and the last follow⁃up，and the above indexes were compared between two groups. Results The follow ⁃up time was（59.2 ± 26.5）weeks. Compared with the Philos plate group，the Multiloc intramedullary nail group had shorter operation time（P = 0.013）and less intraoperative blood loss（P＜0.001）. At the follow⁃up of 12 weeks after operation，the VAS score was lower（P＜0.001），ASES score and Constant score were higher （PASES = 0.011，Pconstant = 0.030），and the difference was statistically significant. At the last follow⁃up，there was no significant difference in VAS score，ASES score，Constant score and the incidence of complications between the two groups（Pvas = 0.308，PASES = 0.105，Pconstant = 0.15，Pcomplications = 0.818）. Conclusion Both Mutiloc intramedullary nail and Philos plate fixations couldachieve good short⁃term outcomesin the treatment ofNeer two⁃ or three⁃part PHF， and the former has shorter operation time，less intraoperative blood lossand better postoperative rehabilitation.

Key words:

proximal humeral fracture, multiloc intramedullary nail, philos plate, open reduction and internal fixation of fracture