三叶草钢板治疗肱骨近端骨折.docVIP

精品论文 参考文献 三叶草钢板治疗肱骨近端骨折 曹克银 渠继武 史方悌 王炜 　　（安徽省淮南市新康医院骨科二病区 安徽淮南 232001） 　　【摘要】目的：探讨三叶草钢板治疗肱骨近端骨折临床疗效及分析。方法：自2003年1月至20013年1月采用三叶草钢板治疗肱骨近端骨折65例，男30例，女35例;年龄23～78岁，平均52岁，车祸伤31例，坠跌伤14例，压砸伤15例，合并肩关节脱位5例；骨折根据Neer分型[1]：Ⅱ型骨折32例，Ⅲ型26例，Ⅳ型7例。合并肩关节脱位5例，合并其他骨折或多发伤12例，采用切开复位钢板内固定术，受伤至手术时间2～10天，平均3.5天。结果：本组随访4～24个月，平均8个月，骨折均愈合，未发生神经血管损伤，59例无肩痛，6例偶有肩痛，所有患者均能完成日常生活动作。根据Neer评分[2]：优41例， 良13例，中8例，差3例，优良率为83％，患者主观满意率为90％。 　　【关键词】肱骨近端骨折 三叶草钢板 内固定 　　【中图分类号】R687 【文献标识码】A 【文章编号】2095-1752（2014）21-0203-02 　　【Abstract】 Objective: To explore the treatment of clover plate of proximal humerus fractures of the clinical efficacy and analysis. Methods: from 2003 January to 20013 January were treated with cloverleaf plate of proximal humeral fractures in 65 cases, male 30 cases, female 35 cases; age 23 ~ 78 years old, with an average of 52 years, 31 cases of traffic accident, falling injury in 14 cases, crush injury in 15 cases, 5 cases with dislocation of shoulder joint; fracture according to Neer; type [1]: type II fractures in 32 cases, 26 patients of type Ⅲ, Ⅳ 7 cases. 5 cases with dislocation of shoulder joint, combined with other fracture or multiple injuries in 12 cases, the use of open reduction and internal fixation, time from injury to operation was 2 ~ 10 days, with an average of 3.5 days. Results the patients were followed up for 4 ~ 24 months, average 8 months, all fractures healed, no nerve and blood vessel injury, 59 cases without shoulder pain, 6 cases with shoulder pain, all patients were able to complete the activities of daily living. According to Neer score [2]: excellent in 41 cases, good in 13 cases, in 8 cases, poor in 3 cases, the excellent and good rate was 83%, the subjective satisfactory rate in patients with 90%. 　　【Key words】proximal humerus fractures of clover plate internal fixation 　　肱骨近端骨折是指肱骨外科颈以远1～2cm至肱骨头关节面的骨折，包括肱骨头、大结节、小结节、肱骨干近端等结构的骨折，以中老年 见，国内文献报道其发生率占全身骨折的2.5%[3],国外文献报道占全身骨折的4%～5%[4]。 肱骨近端骨折的治疗方法受多方面