Abstract: 【Abstract】〓Objective〓To investigate the effect of proximal humerus locking plate and proximal humerus anatomical plate on complex 3- and 4-part fractures of the proximal humerus (Neer classification) in the elders. Methods〓151 cases of proximal humeral fractures were included in the study and divided into proximal humerus anatomical plate group (A group, n=65 cases) and proximal humerus locking plate group(B group, n=86 cases) according to different operation methods. The patients of A group underwent fracture fixation by anatomical plate and those in B group received fracture fixation by locking proximal humerus plate. The treatment effect was evaluated in two groups and compared between two groups by Neer score and Constant score. Results〓The mean humerus healing time of B group was significant superior to A group (P<0.05). Neer score, constant score, pain, function, activity and total score of shoulder in B group were significant superior to those in A group in 1 year and 2 years after operation (P<0.05). Conclusion〓Proximal humerus locking plate and proximal humerus anatomical plate could be used for three-and four-part of proximal humeral fractures in the elders, but proximal humerus locking plate has andvantage for humerus healing time, functional rehabilitation.

Key words: Proximal humerus fracture, Neer score, Constant score, Locking plates

摘要： 【摘要】 目的〓探讨肱骨近端解剖钢板与肱骨近端解剖锁定钢板治疗老年肱骨近端Neer三、四部分骨折的功能及疗效差异。方法〓收集有完整随访资料的151例老年Neer三、四部分骨折患者,按手术方式分为肱骨近端解剖钢板组(A组,65例)和肱骨近端解剖锁定钢板组(B组,86例),在随访过程采用Constant评分及Neer评分评价并比较两组疗效。结果〓B组平均愈合时间显著短于A组(P<0.05)。两组的术后1年和术后2年功能比较:B组Neer评分的疼痛、功能、活动度及总分均显著优于A组(P<0.05);B组Constant评分的疼痛、日常生活活动、主动活动及总分显著优于A组(P<0.05)。结论〓肱骨近端解剖钢板与肱骨近端解剖锁定钢板均可用于老年Neer三、四部分骨折,但解剖锁定钢板愈合更快,功能恢复更好,临床推荐优先使用。

关键词: 肱骨近端骨折, Neer评分, Constant评分, 锁定钢板