解剖型钢板内固定治疗肱骨近端骨折39例剖析.docVIP

解剖型钢板内固定治疗肱骨近端骨折39例剖析 　　[摘要] 目的：探讨解剖型接骨板内固定治疗肱骨近端骨折的临床疗效。方法：2005年1月～2010年6月，使用解剖型接骨板内固定治疗肱骨近端骨折39例。根据Neer分型，二部分骨折10例，三部分骨折24例，四部分骨折5例。采用三角肌、胸大肌间隙入路，其中5例因骨缺损行植骨术。结果：本组患者均获随访，随访时间为12～18个月，平均16个月。骨折均愈合，愈合时间4～6个月。按Neer肩关节功能评分标准，优25例，良9例，优良率为87.2%。结论：采用解剖型接骨板内固定和规范的功能锻炼治疗肱骨近端骨折可获得满意疗效。 　　[关键词] 解剖型接骨板；肱骨骨折；骨折固定术；临床疗效 　　[中图分类号] R683.41 [文献标识码]A[文章编号]1674-4721（2011）07（b）-031-03 　　 　　Analysis of anatomical plate fixation of proximal humeral fractures in 39 cases 　　ZHANG Zhigang, LIU Rixin, LI Yumei, CHEN Xuanming 　　Department of Orthopedics, Affiliated Chen Xinghai Hospital of Guangdong Medical College, Zhongshan 528415, China 　　[Abstract] Objective: To study the clincal effect of open reduction and internal fixation with anatomical form plate to treat proximal humeral fractures. Methods: A total of 39 cases with proximal humeral fractures were treated with anatomical form plate from January 2005 to June 2010. According to Neer classification, 10 cases were with two-part fractures，24 with three-part fractures and 5 with four-part fractures. Reduction and fixation was done via dehopectoral-groove approach． Bone graft was applied fo 5 cases. Results: All the 39 cases were folowed up． The follow-up time was 12-18 months, averaged 16 months. All cases were healed and the union period of 4-6 months. According to the Neer shouldel score, the results showed that 25 cases were excellent, 9 cases were good, with excellent rate of 7.2%. Conclusion: For proximal humeral fractures，internal fixation by using anatomical form plateplus normal functional exercises can obtain satisfactory therapeutic results. 　　[Key words] Anatomical form plate; Humeral fractures; Fracture fixation; Clinical effect 　　 　　肱骨近端骨折指包括肱骨外科颈在内及其以上部位的骨折，是临床较常见的创伤是上肢较常见的骨折，文献报道其发病率占全身骨折的4%～5%[1]。部分肱骨近端骨折，移位或成角畸形不明显而不需要手术治疗，部分移位明显或粉碎的骨折需要手术治疗。非手术治疗由于肩关节长期制动，易造成肩关节功能障碍。手术治疗的最大优点是通过内固定或人工关节置换，有利于肩关节早期进行功能锻炼，从而最大程度地减少肩关节功能障碍。2005年1月～2010年6月，本科对39例肱骨近端骨折患者采用切开复位解剖型钢板内固定，功能恢复良好。 　　1 资料与方法 　　1.1 一般资料 　　本组手术治疗