目的探讨髓内钉治疗老年性肱骨近端粉碎性骨折的可行性及临床疗效。方法回顾性分析2015年1月至2016年12月收治的49例老年粉碎性肱骨近端骨折(NeerⅡ~Ⅳ型)患者,按内固定方式分为两组,分别采用肱骨近端锁定钢板(LPHP组)和肱骨近端髓内钉(IPHN组)进行固定。分析两组患者术后肩关节功能恢复情况及影像学资料。结果 IPHN组术后早期(1~3个月)Constant-Murley评分均高于LPHP组,差异具有统计学意义(P<0.05);而远期(术后6个月)随访结果显示,两组Constant-Murley评分和治愈率均无统计学差异(P>0.05)。结论髓内钉可促进老年性肱骨近端粉碎性骨折的早期恢复,但其远期效果无明显优势。

Objective To explore the feasibility and the curative effect of proximal humeral nailing in the treatment of elderly proximal humeral fracture. Methods From January 2015 to December 2016, 49 cases above 70 years old with elderly proximal humeral fracture (NeerⅡ-Ⅳ)were included and reviewed.All cases were divided into 2 groups according to different internal fixation and treated with locking proximal humeral plate (LPHP group) or intramedullary proximal humeral nailing fixation (IPHN group) respectively. The comparability of the basic data of two groups, recovery of shoulder joint function and imaging data were analyzed. Results The difference was considered statistically significant between two groups in the assessment during the early postoperative period(P<0.05).There was no significant difference in the assessment of long-term function after operation(P>0.05).And there was no significant difference in the assessment of cure rate between the two groups (P>0.05). Conclusion IPHN may promote the early recovery of elderly proximal humeral fracture, but its long-term effects have no obvious advantage.