经结节间沟入路应用肱骨近端内锁定系统钢板治疗肱骨近端骨折  

Treatment of proximal humeral fractures with proximal humeral locking system plate via an intertubercular sulcus approach

作　　者：沈诚纯 连霄[1] 孙洪军 曾云记[1] SHEN Cheng-chun;LIAN Xiao;SUN Hong-jun;ZENG Yun-ji(Department of Orthopaedics,Hospital Affiliated to Hangzhou Normal University,Hangzhou 310015,Zhejiang,China)

机构地区：[1]杭州师范大学附属医院杭州市第二人民医院骨科,浙江杭州310015

出　　处：《中国骨伤》2018年第12期1164-1167,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :观察经结节间沟入路应用肱骨近端内锁定系统钢板治疗肱骨近端Neer 2、3部分骨折的疗效。方法:回顾性分析2015年7月至2018年1月采用经结节间沟入路应用肱骨近端内锁定系统钢板治疗肱骨近端Neer 2、3部分骨折15例,男7例,女8例;年龄23～67岁,平均46岁;左侧5例,右侧10例;Neer 2部分骨折7例,Neer 3部分骨折8例。术前和术后随访均拍摄X线片及CT以评估骨折的位置和骨折愈合的情况。临床评价包括Constant-Murley肩关节功能评分、手术并发症的分析。15例均应用肱骨近端内锁定系统钢板治疗,术后均采用Constant-Murley评分评定肩关节功能。结果:15例均获随访,时间14～36个月,骨折全部愈合,愈合时间14～26周,平均19.1周。术后均无肱骨头坏死、腋神经损伤、骨折不愈合等并发症发生。术后3个月Constant-Murley肩关节功能评分72～94分,平均81分,优2例,良13例。结论:采用经结节间沟入路应用肱骨近端内锁定系统钢板治疗肱骨近端骨折手术操作简单,损伤小,术后肩关节功能恢复快。Objective:To observe the effect of proximal humerus internal locking system(PHILOS) plate in the treatment of Neer 2 and 3 part fractures of proximal humerus through tuberosity approach. Methods:From July 2015 to January 2018,15 cases of proximal humerus Neer 2 and 3 fractures were treated with PHILOS plate through intertubercular sulcus approach.There were 7 males and 8 females. The age ranged from 23 to 67 years old,with an average of 46 years old. There were 5 cases on the left side and 10 cases on the right side(including 7 cases of Neer 2 partial fracture and 8 cases of Neer 3 partial fracture). X-ray films and CT were taken before and after operation to assess fracture location and fracture healing. Clinical evaluation included Constant-Murley shoulder function score and operative complications. All 15 patients were treated with the PHILOS. Constant-Murley score was used to evaluate shoulder function after operation. Results:All the 15 cases were followed up,and the duration ranged from 14 to 36 months. All the fractures healed and the healing time ranged from 14 to 26 weeks,averaged 19.1 weeks. There were no complications such as humeral head necrosis,axillary nerve injury and fracture nonunion after operation. At the 3 rd month after operation,the shoulder function score of Constant-Murley ranged from 72 to 94 points,with an average of 81 points;2 cases got an excellent result and 13 good. Conclusion:The PHILOS plate for the treatment of proximal humerus fractures has the advantages of simple operation,small injury and quick recovery of shoulder joint function.

关 键 词：肱骨骨折 骨折固定术 内 外科手术 

分 类 号：R687.3[医药卫生—骨科学]