骨柱植骨结合解剖锁定接骨板治疗肱骨近端复杂3、4部分骨折  

Anatomic locking plate combined with columnar bone graft for surgical management of proximal humerus complex three,four-part fractures

作　　者：孙景福[1] 刘小鹏[1] 王秋实[1] 吴任涛[1] 罗军[1] 王建民[1] 

机构地区：[1]广东医学院附属厚街医院骨科,广东东莞523945

出　　处：《中国伤残医学》2013年第6期16-18,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨骨柱植骨结合解剖锁定接骨板治疗肱骨近端复杂3、4部分骨折的手术方法和临床效果。方法:2008年5月～2011年11月应用骨柱植骨结合肱骨近端解剖锁定接骨板手术治疗肱骨近端复杂3、4部分骨折患者29例,年龄21～59岁,平均年龄36.6岁。应用Neer评分评估治疗效果。结果:29例均获得随访,随访时间12±3.5个月,按Neer疗效评分:优16例,良10例,可2例,差1例,优良率为89.6%。其中3例出现大结节吸收,4例肱骨头坏死,1例行关节置换术,无接骨板断裂和骨折不愈合。结论:复杂的肱骨近端3、4部分骨折多数可进行内固定治疗,采用骨柱植骨结合锁定接骨板內固定可利于骨折的解剖复位和稳定,利于骨折的愈合和关节功能的早期锻炼。Objective：To investigate the surgical methods and clinical results of proximal humerus complex three,four - part fractures by the anatomic locking plate combined with columnar bone graft.Methods：From May 2008 to November 2011,29 patients with three, four - part complex fractures of proximal humerus,aged 21 to 59 years（average age of 36.6 years）,were treated by the columnar bone graft combined with proximal humeral anatomy lock plates.The therapeutic effect was evaluated according Neer Score.Results：All of 29 patients were followed up（12±3.5） months,of which there were excellent in 16 cases,good in 10 cases,moderate in 2 cases and poor in 1 case,and rate of excellent and good was 89.6%.There were three cases with the large nodules absorption,four cases with humeral head necrosis,one accepted routine joint replacement surgery,no broken plate and nonunion.Conclusion：Most of the complex three and four - part fractures of the proximal humerus could be reduced and internal stabilized by the columnar bone graft combined with locking plate fixation in order to the anatomic reduction of the fracture and stability for healing of fracture and the early exercise of joint function.

关 键 词：肱骨近端骨折 骨柱 内固定 锁定接骨板 

分 类 号：R683.4[医药卫生—骨科学]