锁定钛板治疗老年肱骨外科颈骨折

Clinical Results of the Locking Titanium Plates for the Fractures of the Surgical Neck of Humerus in the Aged Patients

目的探讨应用肱骨近端锁定钛板治疗肱骨外科颈骨折的手术方法和疗效。方法应用肱骨近端锁定钛板治疗60岁以上肱骨外科颈骨折32例,对其疗效进行回顾性分析。结果本组32例均获随访,平均13(4～31)个月,骨折均在平均68(66～70)d内达到骨性愈合,肩关节功能按Neer评分法:优23例,良6例,可3例。结论锁定钛板设计合理,固定强度能达到早期功能锻炼的要求,而且手术时不需过多剥离软组织,减少肩袖损伤和肱骨头坏死的发生率,特别是其特殊的依靠钛板与螺钉之间的成角稳定性的固定方式更适合不同程度的骨质疏松老年肱骨外科颈患者,是治疗老年肱骨外科颈骨折的较好内固定方法。

Objective To discuss the surgical techniques and the therapeutic effects of the locking titanium plates for the fractures of the surgical neck of humerus in the aged patients.Methods 32 old patients of surgical neck of humerus fractures were undergone the surgeries of the internal fixation with the locking titanium plates.The clinical data was retrospectively analyzed.Results All the cases were followed up for 13（4~31） months,and all the fractures got bone union within 68（66~70） days.The scores of the joint function were 23 of excellent,6 of good and 3 of fair according to the Neer Evaluation.Conclusions It is recommended of the locking titanium plate of its reasonable design and its fixed-intensity,which can achieve the early exercise for the early functional requirements.The surgery does not need excessive soft tissue dissection,so as to reduce the rotator cuff injury and the incidence of humeral head necrosis.In particular,the special fixation of the angular stability mode between the plate and the screws is more suitable for different levels of osteoporosis in the elderly surgical neck humerus patients.