肱骨近端骨折锁定加压接骨板内固定治疗肱骨近端骨折

Treatment of humeral proximal fracture with locking proximal humeral plate

目的总结肱骨近端骨折锁定加压接骨板(locking proximal humerus plate,LPHP)内固定治疗肱骨近端骨折的临床疗效。方法2003年8月-2006年2月,使用LPHP内固定治疗肱骨近端骨折19例,平均58．6岁。根据Neer分型,二部分骨折2例,三部分骨折9例,四部分骨折8例,其中骨质疏松7例。采用三角肌、胸大肌间隙入路,其中5例因骨缺损行植骨术。结果所有19例患者均得到随访,随访时间3～32个月,平均17个月,骨折均愈合,愈合时间3～5个月。按Neer肩关节功能评分标准评定：优10例,良6例,优良率84%。结论LPHP治疗肱骨近端骨折具有固定可靠,退钉率低,并发症少等优点,特别适用骨质疏松的肱骨近端粉碎性骨折。

Objective To summarize the clincal effect of open reduction and internal fixation with locking-proximal-humerus-plate （LPHP） to treat proximal humeral fractures. Methods A total of 19 eases with proximal humeral fractures were treated with LPHP from August 2003 to February 2006 in this study. Their mean age was 58.6 years old. According to Neer classification, two cases were with twopart fractures, nine with three-part fractures and eight with four-part fractures including seven cases with osteoporosis. Reduction and fixation was done via dehopectoral-groove approach. Bone graft was applied for five eases. Results The follow-up period was 3 to 32 months （ mean 17 months ）. All cases were healed and the union period of 3 - 5 months. According to the Neer shoulder score, the results showed that ten eases were excellent, 6 cases good, with excellent rate of 84%. Conclusion The LPHP method is suitable for osteoporosis and comminuted proximal humeral fractures and enhances the treatment effect.