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目的 通过Meta分析探讨锁定钢板(LP)及半肩关节置换(HA)治疗肱骨近端骨折(PHFs)术后并发症及疗效的差异.方法 计算机检索Pubmed、Cochrane图书馆、EMBASE、ScienceDirect、中国知网、万方、维普等数据库.搜集有关LP/HA治疗PHFs的各种对照研究,纳入标准:随机或非随机对照试验;行LP和HA治疗;年龄≥45岁;随访时间>3个月;可提取到可靠的数据.排除标准:病例数少于10例;其他治疗方式;病例报告,综述,动物实验以及系统评价;多种原因不能耐受手术;病理性骨折或者肱骨近端陈旧性骨折;既往有肩关节外伤及手术病史.研究共纳入27项研究2082例患者,对纳入的文献选择总并发症、常见并发症(肩关节不稳、关节僵硬、肩峰下撞击症)、术后功能评分(Constant-Murley肩关节评分系统、美国肩肘外科医师协会评分)作为Meta分析的评价指标,采用STATA 14.0分析,对于合并SMD或者OR,Pthree months; reliable data can be extracted. Exclusion criteria: the cases were less than 10; other treatment methods; case reports, reviews, animal experiments and systematic reviews; reasons cannot tolerate surgery; pathological fractures OR old fractures of the proximal humerus; history of shoulder injury and surgery. A total of 2 082 patients from 27 trials were included in this mata-analysis. STATA 14.0 was used to analyze the trials included in terms of total complications, common complications (shoulder instability, shoulder stiffness, subacromial impingement), postoperative functional scores, including Constant-Murley scores (CMS) and rating scales of American Shoulder and Elbow Surgeons (ASES) by meta-analysis. For combined SMD or OR, P＜0.05 means significant difference. Results There were significant differences in total complications [OR=1.73, 95% CI (1.35,2.21), P＜0.01], subacromial impingement [OR=0.25, 95% CI (0.11, 0.55), P＜0.01], which HA group were lower; while muscle strength of upper limbs score [SMD=1.857, 95% CI (0.80., 2.912),P＜0.01], range of motion [SMD=2.542, 95% CI (1.273, 3.811, P＜0.01], but not significant differences in CMS and ASES. Conclusion HA may have lower rate of overall incidence complications than LP, both of them could have similar shoulder function recovery.