肱骨距支撑螺钉在肱骨近端Neer Ⅲ、Ⅳ型骨折中的应用分析  

Analysis of application of humeral calcar supporting screws to Neer type Ⅲ and Ⅳ proximal humeral fracture

作　　者：任磊[1] 孙永青[1] 郝敬东[1] 崔准[1] 韩云毅[1] 蒋育欣 靳凯峰 

机构地区：[1]首都医科大学电力教学医院骨科,北京100073

出　　处：《北京医学》2017年第2期157-159,共3页Beijing Medical Journal

摘　　要：目的探讨应用PHILOS接骨板治疗肱骨近端Neer Ⅲ、Ⅳ型骨折中,是否应用肱骨距支撑螺钉对骨折愈合及功能康复的影响。方法对47例应用PHILOS接骨板行手术治疗的肱骨近端Neer Ⅲ、Ⅳ型骨折患者行回顾性研究及临床随访,根据术中是否应用肱骨距支撑螺钉分组,比较2组患者的一般资料(性别、年龄、BMI、患侧、骨折分型、骨密度),及2组的手术时间、术中失血量、骨折愈合时间、颈干角丢失量、随访时Constant-Murley肩关节功能评分。结果 2组患者性别、年龄、BMI、患侧、骨折分型、骨密度比较差异均无统计学意义(P>0.05);2组手术时间、术中失血量、骨折愈合时间比较差异均无统计学意义(P>0.05);支撑螺钉组的复位丢失程度及Constant-Murley评分均优于无支撑螺钉组(P<0.05)。结论在PHILOS接骨板治疗肱骨近端Neer Ⅲ、Ⅳ型骨折手术中应用肱骨距支撑螺钉可以使骨折复位及固定更加牢靠,术后功能康复更加满意。Objective To investigate and analyze the clinical outcomes of application of humeral calcar supporting screws in operation of proximal humeral fracture in Neer type Ⅲ and Ⅳ by PHILOS system. Methods Forty-seven cases receiving operation of proximal humeral fracture in Neer type Ⅲ and Ⅳ by PHILOS system were retrospectively studied and followed up, and patients were divided into the supporting-screw group or the no-supporting-screw group.The related factors （gender, age, BMI, affected side, fracture type, bone density） were compared, and the postoperative factors were also compared operation duration, operative blood loss, fracture union time, humeral neck angle loss, shoulder function score with Constant-Murley. Results There was no significant difference between the two groups in the related factors such as gender, age, BMI, affected side, fracture type, bone density （P〉0.05）. And there was no significant difference in factors such as operation duration, operative blood loss and fracture union time （P〉0.05） either. Humeral neck angle loss and shoulder function score with Constant-Murley were advanced in the supporting-screw group （P〈0.05）. Conclusion Application with humeral calcar supporting screws for proximal humeral fracture in Neer type Ⅲ and Ⅳ leads to more finn reduction and fixation of the fracture, and postoperative functional rehabilitation is more satisfatory.

关 键 词：肱骨近端骨折 PHILOS接骨板 肱骨距 支撑螺钉 

分 类 号：R687.32[医药卫生—骨科学]