肱骨近端骨折的手术策略  

Surgical Option to Treat Proximal Humeral Fracture

作　　者：金晨[1] 陆雄伟[1] 朱彤[1] 丁勇[1] 胡小鹏[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院骨科,上海200011

出　　处：《医学临床研究》2008年第9期1610-1613,共4页Journal of Clinical Research

摘　　要：【目的】总结治疗肱骨近端移位骨折的手术方法及策略。【方法】采用手术治疗肱骨近端骨折32例，男19例，女13例，平均年龄56．8岁，平均随访时间10．5个月；单纯螺钉固定5例，解剖支持接骨板固定15例，肱骨近端锁定板固定9例，肱骨近端髓内钉固定1例，人工肱骨头置换2例；术后早期均行功能锻炼。【结果】术后患者平均随访10．5（3～28）个月。肩关节功能按Constant评分标准，平均82（45～95）分，其中优10例，良16例，可5例，差1例，优良率81．3％。【结论】根据骨折类型、患者年龄、骨质差异、全身状况、合并损伤，选择不同治疗方法治疗不稳定型肱骨近端骨折，并注意使用合适固定，保护血供，重视关节囊和肩袖修复，早期功能锻炼，可促进骨折愈合及肩关节功能恢复。[Objective] To investigate the clinical results of operative treatment of proximal humeral fracture. [Methods] Thirty two patients of proximal humeral fracture（male 19, female 13. average age 56.8 years old） were treated with operation and followed up for 10.5 months （3-28 months）. Five cases were fixed with screws, 15 cases with anatomic plate, 9 cases with locking proximal humerus plate, 1 case with proximal humeral intramedullary nail, and 2 cases were treated with replacement of the head of humerus. Early rehabilitation was done after operation. [Results] All cases were followed up for 10.5 months in the average. According to the Constant Score, the average for all fractures was 82 points. The clinical evaluation results were excellent 10 cases, good 16 cases, improved 5 cases and poor 1 case. The excellent and good rote was 81. 3%. [Conclusion]Different methods for operative treatment of proximal humeral fracture is recommended according to the type of fractures, the age of patient, quality of the bone, general condition of the patient and the combi- nation of injury. It＇s important to limit the damage to soft tissue and blood supply. To obtain excellent and good results, repairing the rotator cuff and joint capsule is necessary, and early rehabilitation of the shoulder must be emphasized.

关 键 词：肩骨折/外科学 

分 类 号：R683.41[医药卫生—骨科学]