目的：研究不同内固定方案在肱骨近端骨折大龄患儿中的应用效果。方法回顾分析2009年3月至2014年2月在临沂市人民医院接受治疗的102例肱骨近端骨折大龄患儿的临床资料，根据不同的内固定方式，分为 A 、B 、C 3组。 A 组34例，采用弹性髓内针逆行髓内固定手术治疗；B 组32例，采用切开复位克氏针内固定手术治疗；C 组27例，采用切开复位接骨板内固定手术治疗。对比3组患儿的手术治疗效果。结果3组患者在手术时间、住院时间、骨折愈合时间、术后肩关节 Neer 评分的优良率、并发症发生率上差异无统计学意义（P＞0．05）。相对 B 组和 C 组，A 组患者术中出血量明显减少、切口长度明显缩短（P＜0．05）。结论弹性髓内针逆行髓内固定、切开复位克氏针内固定、切开复位接骨板内固定均能够安全、有效固定大龄儿童的肱骨近端骨折，弹性髓内针逆行髓内固定临床效果更优。%Objective To study the application effect of different internal fixation scheme in older children with proximal hu-merus fractures .Methods The clinical data of 102 cases of elder children with proximal humerus fracture from March 2009 to Feb-ruary 2014 in the hospital were retrospectively analyzed according to different internal fixation methods ,they were divided randomly into A ,B ,C group ,34 cases in group A ,using elastic intramedullary retrograde intramedullary internal operation ;32 cases in group B ,using open reduction and Kirschner wire internal fixation operation ;27 cases in group C ,using open reduction and plate internal fixation operation .Compared and study the operation treatment effect on children in three groups .Results The operation time ,hos-pitalization time ,fracture healing time ,the excellent and good rate of postoperative shoulder joint Neer score ,complication rate of patients among the three groups had no statistical significance (P > 0 .05) .Compared with group B and group C ,the amount of bleeding was significantly decreased and incision length was significantly shortened in group A(P< 0 .05) .Conclusion Elastic intr-amedullary retrograte internal fixation ,kirschner wire interal fixation ,open reduction internal fixation ,all can fix proximal humeral fractures in older children safely and effectively ,and the clinical effect of elastic intramedullary retrograte internal fixation is better than other two fixation .
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