肱骨近端骨折的处理

Management of proximal humerus fractures

肱骨近端骨折是临床上常见的骨折之一,国外称之为“unsolved fracture”。肱骨近端骨折类型复杂,预后较差,是创伤骨科治疗中的难点,也是研究的重点。笔者根据国内外相关文献资料,复习了肱骨近端解剖、各种临床分型、治疗方法及其优缺点。主张对肱骨近端1部和移位不大的2部骨折行保守治疗,移位大的2、3、4部骨折行手术治疗。强调微创技术,保护骨折周围软组织及血运,修复肩袖,固定坚强,早期练功,辅以物理康复治疗,方能获得满意的临床效果。

The proximal humerus fractures is one of the common fractures named ＂unsolved fracture＂. Because of its complicated classification, the prognosis is poor and the treatment is very difficult. The author reviewed some papers relative to proximal humerus fractures, including the anatomy of proximal humerus, the classification of proximal humerus fractures,and the benefits of various therapies. The part Ⅰ and mild displaced part Ⅱ fracture should be treated conservatively,severely displaced part Ⅱ, Ⅲ, Ⅳ fractures should be operated. Microtrama-tech- nique, preserving soft tissues and circulation, repairing rotator cuff, strong fixation, earlier exercise and physical treatment are all important.