肩外侧入路治疗肱骨近端骨折

Treatment of Proximal Humerus Fractures with Shoulder Lateral Approach

目的：探讨肩外侧入路治疗肱骨近端骨折的临床疗效.方法：2008年6月至2009年4月,采用肩外侧入路肱骨近端锁定钢板（LPPH）固定术治疗肱骨近端骨折24例,其中右侧13例,左侧11例.按Neer分型,二部分骨折8例,三部分骨折13例,四部分骨折3例.结果：本组患者术中无神经、血管损伤,骨折复位良好,内固定可靠,术后均诉骨折部疼痛明显减轻.24例均获随访,随访时间8～15月,平均12.2月.骨折均在6个月达到骨性愈合,患肩关节Neer评分81～97分,均分88.7分.结论：肩外侧入路是治疗肱骨近端骨折的一种有效、安全的手术入路.

Objective： To explore the treatment of proximal humerus fractures with approach of shoulder lateral. Methods： From June 2008 to April 2009, 24 patients with proximal humerus fractures were treated by open reduction and internal fixation using locking plate of proximal humerus （LPPH） with approach of shoulder lateral. The left side was involved in 13 eases, and the right side was involved in 11 eases. The interval be- tween injury and surgery averaged 4.4 days （ 1 - 11 days）. According to Neer classification, 8 cases belonged to 2 parts, 13 to 3 parts, and 3 to 4 parts. Radiographic finding and Neer scoring system were used to evaluate the clinical outcomes. Results： There were no artery and nerve damages during operation of 24 patients. The mean time of follow - up was 12.2 months （ 8 - 15 months）. The union time for 24 cases averaged 6 months. The average Neer score was 88. 7 at the last follow - up evaluation. Conclusions：The approach of shoulder lat- eral is one of the effective and safe ways for the treatment of proximal humerus fractures.