复杂性肱骨近端骨折的外科治疗

Surgical treatment of complex fractures of the proximal humerus

[目的]研究采用切开囊内复位技术和带锁钢板(locking proximal humeralplate,LPHP)内固定治疗复杂性肱骨近端骨折的临床治疗效果。[方法]2002年6月～2004年1月收治30例3、4部分肱骨近端骨折患者,所有骨折均采用切开囊内复位技术进行治疗,采用Neer骨折分类及评分标准进行手术疗效的评价。[结果]最后随访时骨折都顺利愈合,3、4部分骨折优良率分别为94%、89.6%,未发现肱骨头缺血性坏死。[结论]采用切开囊内复位技术和LPHP带锁钢板内固定治疗肱骨近端骨折可减轻肱骨头血供影响,提高骨折复位的有效性和固定的稳定性。

[Objective] To study the treating result of complex proximal humeral fractures using the techniques of open intracapsular reduction and internal fixation with locking proximal humeral plate （LPHP）. [Method] A group of 30 cases of three and four part proximal humeral fractures （ from Jun. 2002 to July 2004 ） were treated with the techniques of open intracapsular reduction. Neer fracture classification and rating system were used. [Result] All the fractures had healed successfully. Of the three and four part fractures, the satisfactory rates were 94% and 89.6% respectively. Avascular necrosis of humeral head did not occur in all fractures. [ Conclusion ] The operative techniques of open intracapsular reduction and internal fixation with locking proximal humeral plate can enhance validity of reduction and stability of fixation, and alleviate the disturbance on vascular supply of the humeral head.