锁定钢板治疗复杂肱骨近端骨折的临床分析.docVIP

锁定钢板治疗复杂肱骨近端骨折的临床分析 编辑。作者：黄海晶，庞贵根，张铁良，张亚非，张涛 【摘要】 ［目的］探讨应用锁定加压接骨板治疗肱骨 近端复杂骨折的疗效。［方法］XX年4月?XX年6月，应用 锁定加压接骨板治疗肱骨近端骨折21例，男13例，女8例； 年龄26?71岁，平均岁。根据Neer分型，3部分骨折15例， 其中5例伴前脱位，6例伴有原发性骨质疏松；4部分骨折6 例，其中3例伴肱骨头前脱位，2例伴后脱位。手术采用三 角肌、胸大肌间隙入路，将锁定钢板置于结节间沟后缘10mm, 近端距肱骨大结节顶点下5mm的位置，复位后骨折断端如有 骨质缺损，进行自体或异体骨植入，骨折远近端分别用锁定 及非锁定螺钉固定。术后第3d肩关节适量被动活动，1周后 开始主动活动，2周后加强功能锻炼。［结果］本组2 1例手 术患者均获得10?14个月的随访，平均个月，骨折12个月 内全部愈合。按Neer肩关节功能评分标准评定：优11例, 良7例，可3例，全组优良率85%。［结论］锁定钢板的螺钉 锁扣于接骨板上，能够提高对肱骨近端粉碎骨折及伴有骨质 疏松患者的固定效果，做到骨折愈合与功能锻炼同步，但应 注意对锁定接骨板的合理操作，尽量避免锁定引起的一系列 问题。 【关键词】近端肱骨骨折；骨折内固定术；锁定加压 接骨板 Abstract : [Objective] Todiscussthe treatmenteff ectoflocking compressionp late(LCP)for proximalhume ralcomplicat edfractures?[Method] Aret rospectivest udywasdoneon21casesofpro ximalhumeral fracturestre atedwithLCPf romAprilXXto Junewerel3ma leand8female , wit hageof26~7 Ito Neercla ssif ica tion, 15caseswere t hree partfra cturesinclud ing5caseswit hanteriordis locationand6 caseswithpri maryosteopor osis；6casesw erefour part fracturesinc luding3cases withanterior dislocationa nd2caseswithposteriorand fixationwere done byde Ito pec to ral gap approach, the opera torputt helockingpla teonlOmmposi teriortothei ntergrooveof tuberosity,5 mmawayfromth etipofhumera lgreaterther ewerebonedef ectsinthefra cturesiteaft erreduction, asdone, which wasgra.dually intensifiedt woweeksafter operation. [R esult] Twenty onecaseswer efollowedupf orl0-14month s,averagemon ths,allfract ureswereunio ninl2toNeers houlderscore , theresultwa sexcellentin llcases, good in7andfairin3, withexcell entandgoodra teof85%. [Con elusion] Thes crewofLCPcan locktheplate sothatthepla tecanfirmlyf ixatetheprox imalhumeralc omminutionfr acturesandos teoporosisbo ne, sosimulta neouslyreach fractureunio nandfunction exercise,but attentionssh ouldbepaidto thesuitableprocedureofLC Ptoavoidaser iesofproblem of lockingpla te. theyweretrea tedwithallografts,lockingscrewsandunlockingscrew sweredrilledintoproximalanddistalpartoftheexerci seshouldbeperformedpassi