微创技术结合长型锁定钢板治疗肱骨近端伴肱骨干骨折

Minmally Invisve Techique with Long Proximal Locking Plate for Treatment of Proximal Humerus and Humeral Shaft Fracture

目的总结微创技术结合长型锁定钢板(LCP)治疗肱骨近端伴肱骨干骨折的临床疗效。方法采用微创技术结合长型LCP桥接技术治疗肱骨近端伴肱骨干骨折46例。结果所有患者获得随访,时间6～24个月,平均18.5个月。43例术后6个月骨折愈合,3例出现肱骨头坏死,再次行人工肱骨头置换,出现肩关节撞击2例,予以去除内固定物,加强功能锻炼,患者症状好转,5例出现桡神经损伤症状,未进行特殊处理,3个月后恢复,所有患者无钢板断裂,无钢板松动。采用Neer标准评定肩关节功能:优18例,良22例,可3例,差3例,优良率87.0%。结论采用微创技术结合长型LCP治疗肱骨近端伴肱骨干骨折,可获得满意的疗效。

Objective To evaluate the clinical outcomes of minimally invasive plate osteosynthesis with long-bridge-type locking plate in the treatment of proximal hunlerus and humeral shaft fractures. Methods Tile combination of minimally invasive treatment of longbridge-type LCP was performed on 46 patients with proximal humerus and humeral shaft fl＇actures. Results All cases were followed up for 6-24 months （average 18.5 months）, 3 case suffered from humeral head necrosis and received the secondary operation of humeral head replacenlent. Shoulder impingement of 2 cases was treated with internal fixation removal and enhanced functional exercise, and the symp- tOlnS were relieved. Five cases had symptoms of radial nerve paralysis, and received no turther treatment, which disappeared within 3 months. No such complications as plate breakage, and internal fixation loosening occurred. By Neer scoring system, 18 cases were graded as excellent, 22 as good, 3 as fair, 3 as poor, and the excellent and good rate was 87.0%. Conclusion The long-bridge-type LCP of minimally invasive technologies for treatment of proximal humerus and humeral shaft fractures can achieve good effect.