锁定加压钢板内固定治疗老年肱骨近端骨折

Locking Compression Plate for the Treatment of Proximal Humeral Fractures in Elderly Patients

目的：报告锁定加压钢板治疗肱骨近端骨折的方法及临床疗效。方法：2006年6月～2010年1月，采用开放复位、锁定加压钢板内固定治疗肱骨近端骨折37例，其中男16倒，女21倒；年龄62～79岁，平均69．7岁。骨折按Neer分型法，二部骨折13例，三部骨折18例，四部骨折6例。术后随访时间12～18个月，平均14个月，根据肩关节功能Neer评分标准进行临床疗效评定。结果；术后12个月按肩关节功能Neer评分标准，优17例，良17例，可3例，优良率91．9％。发生肱骨头缺血性坏死1例。无螺丝钉松动、断裂及内固定失败发生。结论：锁定加压钢板治疗老年肱骨近端骨折复位满意，固定牢靠，操作简单，创伤较少，具有疗效佳、康复快、功能好等优点，是手术治疗老年肱骨近端骨折安全、有效的内固定方法之一。

Objective To report the methods and clinical effects of locking compression plate for the treatment of proximal humeral fractures. Methods From June 2006 to January 2010,37 patients with proximal humeral fractures, including 16 males and 21 females, were treated with surgical reduction and internal fixation with locking compression plate. The mean age of the patients was 69.7 years（62~ 79years）. According to Neer classification,I3 eases were two--part fractures, 18 cases were three--part fractures, 6 cases were four--part fractures. The follow--up period ranged from 12 to 18 months with a mean of 14 months. The clinical results were assessed according to Neer scores of shoulder joint. Results According to the Neer shoulder score standard, 17 cases were excellent, 17 cases were good and 3 cases were fair at 12 months postoperatively and the satisfactory rate was 91.9 %. One case occurred avascular necrosis of femoral head. No screw sliding, dislodging and fixation failure were found during follow--up. Conclusion In the treatment of proxi- mal humeral fractures, locking compression plate not only maintains satisfying reduction with reliable fixation, but also manipulates simply and invades slightly, thus gets good curative effect, fast recovery, satisfying function and so on. So it is one of the effective fixation techniques for the treatment of proximal humeral fractures in elderly patients.