解剖型接骨板内固定治疗肱骨近端骨折

Treatment of Humeral Proximal Fracture with Anatomical Form Plate

目的探讨解剖型接骨板内固定治疗肱骨近端骨折的临床疗效。方法2000年1月—2005年12月,使用解剖型接骨板内固定治疗肱骨近端骨折36例。根据Neer分型,二部分骨折9例,三部分骨折21例,四部分骨折6例。采用三角肌、胸大肌间隙入路,其中3例因骨缺损行植骨术。结果本组患者均获随访,随访时间为6～24个月,平均15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:优25例,良8例,优良率为91.7%。结论采用解剖型接骨板内固定和规范的功能锻炼治疗肱骨近端骨折可获得满意疗效,有效降低了骨折凝肩或肩峰撞击症的发生率。

Objective To study the clincal effect of open reduction and internal fixation with anatomical form plate to treat proximal humeral fractures.Methods A total of 36 cases with proximal humeral fractures were treated with anatomical form plate from January 2000 to December 2005. According to Neer classification,9 cases were with two-part fractures,21 with three-part fractures and 6 with four-part fractures. Reduction and fixation was done via deltopectoral-groove approach. Bone graft was applied for 3 cases. Results All the 36 cases were followed up.The follow-up time was 6-24 months,averaged 15 months. All cases were healed and the union period of 3-5 months. According to the Neer shoulder score,the results showed that 25 cases were excellent,8 cases good,with excellent rate of 91.7%. Conclusion For proximal humeral fractures,internal fixation by using anatomical form plate plus normal functional exercises can obtain satisfactory therapeutic results and reduce the incidence of frozen shoulder of fracture area and acromion impingement syndrome .