PHILOS锁定加压接骨板与肱骨近端锁定加压接骨板治疗肱骨近端骨折

PHILOS and locking proximal humerus plate for fractures of the proximal humerus

背景:PHILOS锁定加压接骨板和肱骨近端锁定加压接骨板均是国际内固定研究学会根据生物接骨的理念,以及肱骨局部解剖特点和生物力学特性研究设计的新一代接骨板。目的:对比分析PHILOS锁定加压接骨板和肱骨近端锁定加压接骨板手术治疗肱骨近端骨折的临床疗效。方法:49例肱骨近端骨折患者按照植入接骨板的不同随机分成2组,PHILOS组:24例,三部分骨折13例,四部分骨折11例,采用PHILOS锁定加压接骨板内固定;LPHP组:25例,三部分骨折15例,四部分骨折10例,采用肱骨近端锁定加压接骨板内固定。两组均经胸大肌三角肌入路,用Neer肩关节功能评分标准行术后患肩功能评分,对两组疗效行统计学比较。结果与结论:PHILOS组22例、LPHP组23例获得随访,平均随访(15.6±4.8)个月。3个月内显示骨折愈合PHILOS组16例、LPHP组18例;6个月内显示骨折愈合PHILOS组21例、LPHP组21例;1年内均全部达骨性愈合。按Neer功能评分标准,患侧肩关节功能:PHILOS组优9例、满意11例,优良率达91%;LPHP组优10例、满意11例,优良率达91%。提示PHILOS锁定加压接骨板和肱骨近端锁定加压接骨板治疗肱骨近端均具有固定牢靠、并发症少、满意率高等优点,是较好的治疗肱骨近端骨折的内置物,但若合并肱骨干骨折PHILOS锁定加压接骨板疗效可能更满意。

BACKGROUND：PHILOS locking compression plate and locking proximal humerus plate （LPHP） are plates of new generation that are designed by international society of internal fixation according to the concept of biological osteosynthesis and local anatomic features of the humerus and biomechanical properties. OBJECTIVE：To compare the clinical effect of open reduction and internal fixation for the fractures of proximal humerus with PHILOS and LPHP blade plate. METHODS：A total of 49 cases of fractures of proximal humerus were randomly divided into two groups （PHILOS,n=24,3 parts in 13 cases and 4 parts in 11 cases; LPHP,n=25,3 parts in 15 cases and 4 parts in 10 cases） according to different implanted plates. All the cases were operated via deltoid-pectoral approach,and Neer numerical rating system was employed to evaluated postoperative function of the involved shoulders. RESULTS AND CONCLUSION：The 22 cases in PHILOS group and 23 cases in LPHP group were followed up for a mean time of （15.6±4.8） months. A total of 16 cases in PHILOS group and 18 cases in LPHP group obtained a bone union recover within 3 months and 21 cases in PHILOS group and 21 cases in LPHP group within 6 months,and all within 1 year. According to the Neer numerical rating system,9 patients in PHILOS group showed a excellent result,11 satisfactory,with an excellent and good rate of 90.9%; 10 patients in LPHP group showed a excellent result,and 11 satisfactory with an excellent and good rate of 91.3%. The treatment for fractures of proximal humerus with PHILOS and LPHP blade plate,which has been approved to be an excellent internal fixation,is able to get a good clinical result,such as stable fixation,few complications and high satisfactory rate. If combined with diaphyseal humerus,PHILOS blade plate is better.