Multiloc髓内钉与PHILOS钢板治疗肱骨近端骨折的疗效分析

Analysis of the Efficacy of Multiloc Intramedullary Nail versus PHILOS Plate in the Treatment of Proximal Humerus Fracture

摘要: 目的：分析比较肱骨近端髓内钉系统(MultiLoc)与肱骨近端锁定钢板(PHILOS)治疗肱骨近端骨折的疗效。方法：对我院103名肱骨近端骨折接受手术的患者随机分成两组，对照组(n = 42)，实验组(n = 61)，对照组采用PHILOS钢板内固定，实验组采用MultiLoc髓内钉内固定，对比两组患者在手术时间、切口长度、术中出血量、术后7天内疼痛视觉模拟评分(VAS)、术后12月肩关节功能评分(Constant-Murley)，术后12月并发症发生率等指标。结果：实验组手术时间、切口长度及术中出血量少于对照组(P < 0.05)，术后7天内术区疼痛视觉模拟评分实验组低于对照组(P < 0.05)，术后12月肩关节功能评分实验组高于对照组(P < 0.05)，术后12月并发症发生率实验组低于对照组(P < 0.05)。结论：Multiloc髓内钉与PHILOS钢板内固定均可有效治疗肱骨近端骨折，Multiloc髓内钉在减轻患者疼痛，减少并发症，加快术后关节功能恢复方面优于PHILOS钢板。

Abstract: Objective: To analyze and compare the efficacy of the proximal humeral intramedullary nail system (MultiLoc) and the proximal humeral internal locking system (PHILOS) in the treatment of proximal humeral fracture. Methods: A total of 103 patients with proximal humeral fractures who underwent surgery in our hospital were randomly divided into two groups: the control group (n = 42) and the test group (n = 61). The control group underwent internal fixation with the PHILOS plate, while the test group underwent internal fixation with the MultiLoc intramedullary nail. The two groups were compared in terms of operative time, incision length, intraoperative blood loss, visual analog scale (VAS) pain scores within 7 days postoperatively, Constant-Murley shoulder function scores at 12 months postoperatively, and the incidence of complications at 12 months postoperatively. Result: The experimental group had shorter operative time, smaller incision length, and less intraoperative blood loss compared to the control group (P < 0.05). The VAS pain scores within 7 days postoperatively were lower in the experimental group than in the control group (P < 0.05). At 12 months postoperatively, the Constant-Murley shoulder function scores were higher in the experimental group than in the control group (P < 0.05), and the incidence of complications was lower in the experimental group than in the control group (P < 0.05). Conclusion: Both the MultiLoc intramedullary nail and the PHILOS plate can effectively treat proximal humeral fractures. However, the MultiLoc intramedullary nail is superior to the PHILOS plate in reducing postoperative pain, decreasing the incidence of complications, and accelerating the recovery of shoulder joint function.