解剖型锁定板加张力带内固定治疗肱骨近端四部分骨折的疗效分析-外科学专业论文.docxVIP

山西医科大学硕士学位论文 山西医科大学硕士学位论文 I I 解剖型锁定板加张力带内固定治疗肱骨近端四部分骨折的疗效 分析 摘 要 目的： 探讨应用解剖型锁定板加张力带内固定治疗肱骨近端四部分骨折的临床疗效。 方法： 对 2011 年 1 月至 2014 年 3 月我科收治的 34 例肱骨近端四部分骨折应用解剖型 锁定板加张力带内固定治疗患者中获得完整随访资料的 30 例，采用 Constant-Murley （CM）肩关节评分系统进行术后功能评分。 结果： 术后随访时间为 6 个月至 24 月，平均( 11.8±5.9 )个月。术后骨折均愈合，无内 固定失效，骨折平均愈合时间为 9.8 周。根据 CM 评分标准，平均( 81.3±12.8 )分，优 15 例，良 11 例，可 3 例，差 1 例；优良率为 86.7%。 结论： 解剖型锁定板加张力带内固定治疗肱骨近端四部分骨折疗效可靠，有利于肩关节 早期功能锻炼，是较理想的手术方法。 关键词：解剖型锁定板 1；张力带 2；内固定 3；肱骨近端骨折 4 II II The therapeutic effects of anatomical locking plate and tension band wire internal fixation of 4-part proximal humeral fractures Abstract Objective： To discuss the clinical therapeutic effects of anatomical locking plate and tension band wire internal fixation of 4-pate proximal humeral fractures. Methods： from January 2011 to March 2014,34 cases patients who sustained 4-part proximal humeral fractures were treated by anatomical locking plate and tension band wire internal fixation in our department,were follow-up.Postoperative functional score were performed by Constant-Murley（CM）scoring system was used to assess the postoperative shoulder jiont functional in 30 cases with complete follow-up. Results： The follow-up time was 6 months to 24 months,with an average of (11.8±5.9) months.Bone union was achieved in all the cases,with average healing period of 9.8 weeks.According to CM scoring ,with average score was (81.3±12.8) points,the results were excellent in 15 cases,good in 11,middle in 3,and poor in 1,the excellent and good result rate was86.7%. Conclusion： Anatomical locking plate and tension band wire internal fixation is an ideal way in operative treatment of 4-pate fractures of proximal humeral,it’s clinical result reliability,besides be beneficial to postoperative early functional exercise of shoulder jiont. Key words : Anatomical locking plate1;Tension band wire2;Internal fixation3;Proximal humeral fractures4 PAGE PAGE 1 前 言 肱骨近端骨折是指肱骨外科颈以远 1~2cm 至肱骨头关节面之间的骨折，包括肱 骨头、大小结节、肱骨干近端等结构的骨折。肱骨近端骨折是临床最常见的骨折之一，