肱骨近端锁定内固定系统(PHILOS)与三叶草钢板治疗肱骨近端隐匿性骨折的临床疗效对比Comparison of clinical efficacy of proximal humerus locking internal fixation system (PHILOS) and Clover plate in the treatment of proximal humerus occult fractures.pdfVIP

提 要 目的：观察肱骨近端锁定内固定系统（Proximal Humerus Internal Locking System，PHILOS）与三叶草钢板内固定术治疗肱骨近端隐匿性骨折的临床疗效并 进行比较。 方法：收集肱骨近端隐匿性骨折的病例共40例，所有患者均为2008-2011年接 受治疗，其中PHILOS组20例，男性7例，女性13例，平均年龄67.1岁（34岁-93 岁）；普通组20例，男性9例，女性11例，平均年龄61.75岁（46岁-76岁）。按 Constant-Murley绝对值评分，回顾性分析比较采用肱骨近端锁定内固定系统 （PHILOS组）与三叶草钢板（普通组）内固定治疗肱骨近端隐匿性骨折的疗效。 Constant-Murley绝对值评分法如下：满分为100分，活动范围40分，主要活动和 日常生活20分，三角肌力量25分，疼痛10分。术后总评分90分以上为优，80-89 分为良，70-79分为可，70分以下为差，优、良、可总和所占的百分比为满意率。 结果：所有40例患者术后随访。采用Constant-Murley绝对值评分，肱骨近端 锁定内固定系统（PHILOS组）的疗效明显优于常规手术方法组（普通组）。PHILOS 组满意率95%。 结论：肱骨近端锁定内固定系统对于复杂的、粉碎的肱骨近端隐匿性骨折是一种 较好的内固定物，其临床疗效优于三叶草钢板。切开复位PHILOS内固定后早期进行 功能锻炼是决定疗效的关键。 关键词：肱骨近端隐匿性骨折；肱骨近端锁定内固定系统；切开复位内固定 Clinical efficacy comparison of the proximal humerus internal locking system (PHILOS) and the clover plate in treatment of proximal humeral shield fractures Speciality: Orthopaedics of TCM Author: Wang Yang Tutor: Prof. Wang Mingxi Abstract Objective: The purpose of this study is to determine the efficacy of the open reduction and fixation of proximal humerus shield fracture with proximal humerus internal locking System (PHILOS) and clover plate. Methods: 40 patients were found to be eligible and were included in the study. These patients had all been treated for a proximal humerus fracture between 2008 and 2011. The mean age of the 20 patients of the PHILOS group was 67.1(34-93), including male 7 cases and female 13 cases, and ordinary group included the other 20 patients, male 9 cases and female 11 cases, with an average age of 61.75 (46-76). According to Constant-Murley absolute score, the clinical effect is retrospectively analyzed by comparing proximal humerus internal locking system (PHILOS) group and clover plate group (ordinary group) of proximal humeral shield fractures.