加长型Philos锁定板治疗肱骨近端骨折伴同侧肱骨干骨折

Extended type philos locking plate for treatment of proximal humerus and humeral shaft fractures

目的研究加长型PHILOS锁定板治疗肱骨近端伴同侧肱骨干骨折的临床疗效。方法回顾性分析2008～2010年收治且获得随访的9例长型PHILOS锁定板治疗肱骨近端伴同侧肱骨干骨折患者资料,男5例,女4例;平均年龄为55.4岁(40～67岁);肱骨近端骨折采用Neer分型,其中二部分骨折7例,三部分骨折2例;肱骨干骨折采用AO分型,A1型5例,B1型3例,C1型1例。术后肩关节功能采用HSS评分,肘关节功能采用Mayo评分。结果所有患者随访平均24个月(14～36月)9例全部达骨性愈合。无桡神经麻痹症状等并发症发生。按Neer肩关节功能评分标准,优4例,良4例,中1例,优良率88.9%;按肘关节HSS功能评分优8例,良1例,优良率100%。结论加长型PHILOS锁定板治疗肱骨近端伴同侧肱骨干骨折固定牢靠、并发症少,治疗效果可靠。

Objective To investigate the treatment effect of the extended type proximal humeral internal locking system (PHILOS) with proximal humeral and ipsilateral humeral shaft fractures.Methods From 2008 to 2010,9 patients with proximal humeral and ipsilateral humeral shaft fractures were treated with extended type PHILOS and followed.There were 5 men and 4 women,aged from 40 to 67 years (average 55.4 years).According to Neer classification,7 cases were two-part fractures,2 cases three-part fractures; According to AO classification,there were 5 cases of type A1,3 cases of type B1,1case of type C1.Postoperatively the shoulder functions were evaluated using Neer scoring system,Elbow functions were evaluated by the Mayo system.Results All patients were followed up for 14-36 months ( average 24 months),which showed fracture healing in all patients,There was no radial nerve palsy or other complications occurred.According to the Neer scoring system:4 were excellent,4 good,and 1 fair,and the excellent and good rate was 88.9%.According to the Mayo score system:8 were excellent,1good,and the excellent and good rate was 100%.Conclusion The treatment of proximal humeral and ipsilateral humeral shaft fractures with extended type PHILOS is good with the advantage of stable fixation,and less complications.