肱骨近端解剖锁定板治疗中老年NeerⅢ、Ⅳ型肱骨外科颈骨折的临床研究Clinical study on the treatment of Neer III and IV type of humerus surgical neck fracture in the middle and old age with the proximal humerus anatomic locking plate.pdfVIP

提 要 目的：观察采用肱骨近端解剖锁定板治疗中老年 NeerⅢ、Ⅳ型肱骨外科颈骨折 的临床疗效，以便提高肱骨外科颈骨折的治愈率。 方法：本研究病例来自山东中医药大学附属医院骨科病房自2008年10月至2011 年10月手术治疗且均获完整随访的39例肱骨外科颈骨折患者。其中男性16例,女性 23例,年龄最大91岁,最小45岁,平均年龄68岁，左侧24例,右侧15例。根据Neer 分型标准，Ⅲ型20例、Ⅳ型19例。术前进行临床诊断及影像学评估，确定手术的时 机；术中注意软组织及血管神经的保护；术后指导患者进行系统的康复功能锻炼并采 取必要的措施预防并发症的发生。术后一年采用Neer肩关节功能评分标准进行评分， 观察疗效。 结果：39例患者，优23例，良13例，可2例，差1例，优良率为92.3%。 结论：采用肱骨近端解剖锁定板是治疗中老年 NeerⅢ、Ⅳ型肱骨外科颈骨折较 为有效的治疗方法；术中注意仔细操作、术后进行系统的功能锻练对肩关节的功能恢 复尤为重要。此种治疗方法值得临床应用及进一步的研究。 关键词 肱骨外科颈骨折；中老年 NeerⅢ、Ⅳ型；手术治疗；肱骨近端解剖锁 定板 The proximal humerus anatomic locking plate for treatment of the elderly to Neer III IV humerus surgical neck fractures of the clinical research Speciality: Orthopaedics of Traditional Chinese Medicine Author: Shen Liang Tutor: Prof. Bi Rong Xiu Abstract Objective: To observe the clinical curative effect on treating unstable type humerus surgical neck fractures with Proximal humeral anatomy of locking plates therapy, so we can improve the Cure rate of Humerus surgical neck fractures. Methods: We get 39 patients (16 male and 23 female, the oldest is 91 years and the youngest is 45, with average age 68) with unstable type humerus surgical neck fractures. The cases were all got surgical treatments (24 cases are from left side and 15 are from right side) and Postoperative follow-up from the orthopedics department of the affiliated hospital of Shandong traditional medicine university, from October 2008 to October 2011. According to the standard of Neer classification, these cases contain 20 cases for the third type, 19 cases for the fourth type. Before surgery, we made clinical and imaging evaluation, make sure the surgery opportunity. During the operation, we paid more attention for protecting the Soft tissue and Ve