锁定钢板结合腓骨植骨治疗骨质疏松性肱骨近端骨折的疗效分析  

Efficacy of locking plate combined with fibular strut graft augmentation in the treatment of osteoporotic proximal humerus fracture

作　　者：何继业[1] 张家红[1] 王栋梁[1] 

机构地区：[1]上海交通大学医学院附属新华医院骨科,上海200092

出　　处：《中国临床医生杂志》2016年第6期35-37,共3页Chinese Journal For Clinicians

基　　金：上海市科委课题(XHEC-D-2014-025)

摘　　要：目的探讨锁定钢板结合异体腓骨植骨治疗骨质疏松性肱骨近端骨折的临床疗效。方法回顾性分析31例（失访4例）应用锁定钢板结合异体腓骨治疗老年骨质疏松性肱骨近端骨折患者的临床资料,术后进行肩关节影像学评价及肩关节功能评分。结果 27例患者获得随访,随访时间18-23个月,平均19.5个月。27例患者中有2例出现肱骨头坏死塌陷,其他均获得骨性愈合,无肱骨头内翻或螺钉穿出,无内固定松动。肩关节功能评分为患侧（77±12）分,健侧（85±10）分。3例患者术后出现伤口渗液,经换药逐步愈合,其他患者伤口愈合良好。结论采用锁定钢板结合腓骨植骨治疗老年肱骨近端骨折,能提高复位质量,有效防止肱骨头复位丢失,并获得良好的肩关节功能。Objective To investigate the Efficacy of locking plate combined with fibular strut graft augmentation in the treatment of osteoporotic proximal humerus fracture. Method We reviewed 31 osteoporotic proximal humerus fractures that were treated with locking plate combined with fibular strut graft augmentation. All clinical and radiological data were collected,Constant score were analyzed. Result Four patients were lost for follow-up,27 patients were followed for18 - 23 months（ average 19. 5 months）. Two patients had humeral head osteonecrosis,others got bony union without humeral head collapse,varus displacement,screw penetration and internal fixation loosening. The mean Constant score at the end of the follow-up period was 77 ± 12 in the corrected shoulder,while the Constant score of the uninjured shoulder was 85 ± 10. Three patients had continuous wound drainage,but healed with dressing change. Conclusion In the treatment of osteoporotic proximal humerus fracture,the locking plate combined with fibular strut graft augmentation could improve the reduction quality,prevent the reduction loss and achieve a good shoulder functions.

关 键 词：锁定钢板 腓骨植骨 肱骨近端骨折 复位丢失 

分 类 号：R683.4[医药卫生—骨科学]