肱骨近端锁定内固定系统治疗老年肱骨近端骨折

The proximal humeral internal locking system(PHILOS) plate for the proximal humerus fractures in the elderly patients

目的评价肱骨近端锁定内固定系(PHILOS)统治疗老年肱骨近端骨折的临床疗效。方法 2008年6月～2010年1月收治老年肱骨近端骨折33例,平均65.4岁(61～78岁),男性12例,女性21例。Neer分型二部分骨折9例,三部分骨折17例,四部分骨折7例。均采用PHILOS内固定治疗,随访12～18个月,平均14.6个月。结果所有患者骨折均获得愈合,1例发生肱骨头坏死,无切口感染或内固定失败。术后1年肩关节Constant-Murley功能评分的优良率:二部分骨折为88.9%,三部分骨折为81.3%,四部分骨折57.1%,总的优良率为75.8%。结论 PHILOS治疗老年肱骨近端骨折可获得较为满意的临床疗效。

【Objective】 To evaluate the treatment outcome of the proximal humeral internal locking system（PHILOS） plate for the proximal humerus fractures in the 32 elders.【Methods】 Fifty-four intertrochanteric fractures patients all over 60 years old were assigned into two groups,and all followed up over 12 months.Twenty-six patients were treated with PFNA,twenty-eight patients were treated with DHS.Wound length,operation time,blood loss,total X-ray exposure time,inpatient time,therapeutic effect and complications were recorded and compared in two groups.【Results】 From April 2008 to January 2010,the 32 elderly patients with proximal humerus fractures were treated by open reduction and internal fixation using the PHILOS plate.There were 11 males and 21 females with average 66.3 years old（range,61-78）.All fractures were classified as 2-part（n =9）,3-part（n =17）,and 4-part（n =7）,according to the Neer classification.Mean follow-up was 14.6 months（range,12-18 months）.【Conclusion】 Open reduction and internal fixation with PHILOS could gain satisfactory therapeutic effects for the proximal humerus fractures in the elderly patients.