肱骨近端骨折的外科治疗  

Surgical Treatment of Proximal Humeral Fractures

作　　者：卫建民[1] 罗琪改[1] 祁文兵 李军[1] 周小庆[1] 

机构地区：[1]宝鸡市中医医院骨伤一科,陕西宝鸡721001

出　　处：《实用骨科杂志》2005年第2期139-140,共2页Journal of Practical Orthopaedics

摘　　要：目的　探讨肱骨近端骨折的外科治疗及术后康复对疗效的影响。方法　2 0 0 0年10月至2 0 0 3年12月,对收治的10 3例肱骨近端骨折患者根据Neer分型及骨折的移位程度分别进行非手术治疗5 5例,手术治疗4 8例。术后早期行外展固定及功能锻炼。结果　经过6～36个月(平均2 0 .4个月)的随访,骨折均愈合。根据Neer评分标准,手术组和非手术组的优良率分别为93.8%和81.8%。结论　肱骨近端骨折移位较小的,一般可采用非手术治疗。对于移位严重的Neer 型和 、型骨折,早期采用开放复位T形和三叶形钢板内固定,术后早期行外展固定及适当的功能锻炼可获得满意的疗效。治疗的关键是准确的复位、可靠的固定和适当的功能锻炼。Objective To investigate the clinical features and surgical treatment of proximal humeral fractures. Methods From October 2000 to December 2003, 103 cases of proximal humeral fractures were classified according to Neer′s classification and severity of displacement degrees. 55 cases were treated by non-operation methods and 48 cases were operated. Early external fixation and normal rehabilitation were couraged. Results All the 103 cases were followed up ranged from 6-36 months with an average of 20.4 months. All cases cicatrized. The function of the injured extremity was evaluated according to Neer′s functional assessment standerd of shoulder joint. The excellent rate of shoulder joint function was 93.8% in the operation group and 81.8% in the non-operation group. Conclusion The cases with low-grade displacement usually were treated by non-operation methods. For fractures with severe displacement of Neers Ⅲ/Ⅳ, internal fixation by using T and trefoil shaped plate plus early external fixation and normal rehabilitation can obtain satisfactory therapeutic results. It is key to a satisfactory curative effect to correctly select the indication, replace exactly,fixup reliably and early functional rehabilitation.

关 键 词：肱骨近端骨折 外科治疗 2000年10月 非手术治疗 功能锻炼 NeerⅡ型 术后早期 2003年 钢板内固定 术后康复 骨折患者 评分标准 骨折移位 开放复位 优良率 疗效 外展 

分 类 号：R683.41[医药卫生—骨科学] R576[医药卫生—外科学]