Department of Orthopaedic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China.
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.
J Orthop Surg Res. 2022 Nov 5;17(1):481. doi: 10.1186/s13018-022-03360-6.
The objective of this study was to evaluate the efficacy of locking plates versus interlocking intramedullary nails in the treatment of proximal humerus fractures to provide clinical data support and theoretical guidance.
Patients with proximal humerus fracture from the Third hospital of Shijiazhuang city and Third hospital of Hebei medical university and from January 2017 to June 2019 were selected, included and divided into the locking plate group and the interlocking intramedullary nail group according to the intervention received. Information pertaining to the perioperative period (operation time, hospital stay, blood loss, etc.) of patients in both groups was collected. VAS pain scores, shoulder activity Constant-Murley scores and postoperative complications were documented. The perioperative data of the two groups were compared, and P < 0.05 was considered statistically significant.
A total of 64 patients were enrolled, including 36 patients in the locking plate group, with a mean age of 61.3 ± 13.9 years, while the mean age of the interlocking intramedullary nail group was 65.6 ± 11.2 years. There was no statistical difference in gender, affected side, injury mechanism and Neer classification between the two groups (P > 0.05). However, the average operation time of the locking plate group was shorter than that of the interlocking nail group (84.9 ± 11.7 vs. 102.6 ± 22.1 min, P = 0.00), and the intraoperative blood loss of the locking plate group (137.4 ± 16.8 ml) was higher than that of the interlocking nail group (72.5 ± 10.5 ml, P = 0.00). There was no significant difference in the VAS score and Constant-Murley score between these two groups at the final follow-up.
Interlocking intramedullary nails are more minimally invasive than locking plates, but fracture reduction and fixation take longer. There was no significant difference in pain and shoulder function scores between the two internal fixation strategies for the treatment of proximal humerus fracture.
本研究旨在评估锁定钢板与交锁髓内钉治疗肱骨近端骨折的疗效，为临床提供数据支持和理论指导。
选取 2017 年 1 月至 2019 年 6 月石家庄市第三医院和河北医科大学第三医院收治的肱骨近端骨折患者，按所接受的干预措施分为锁定钢板组和交锁髓内钉组。收集两组患者围手术期（手术时间、住院时间、出血量等）的信息。记录 VAS 疼痛评分、肩关节活动 Constant-Murley 评分和术后并发症。比较两组围手术期数据，P<0.05 为差异有统计学意义。
共纳入 64 例患者，其中锁定钢板组 36 例，平均年龄 61.3±13.9 岁，交锁髓内钉组 28 例，平均年龄 65.6±11.2 岁。两组患者性别、患侧、损伤机制和 Neer 分型比较差异无统计学意义（P>0.05）。但锁定钢板组的平均手术时间短于交锁髓内钉组（84.9±11.7 比 102.6±22.1 min，P=0.00），术中出血量（137.4±16.8 ml）多于交锁髓内钉组（72.5±10.5 ml，P=0.00）。末次随访时两组 VAS 评分和 Constant-Murley 评分比较差异无统计学意义。
交锁髓内钉比锁定钢板更微创，但骨折复位和固定时间更长。两种内固定策略治疗肱骨近端骨折的疼痛和肩关节功能评分无显著差异。
