锁定钢板加同种异体骨移植治疗肱骨近端复杂骨折

Locking plate for proximal with bone transplantation treatment humeral complicated fractures

目的探讨应用肱骨近端锁定钢板加同种异体骨移植治疗Neer3部分、4部分肱骨近端骨折的临床疗效。方法 2008年4月-2011年6月,应用锁定加压接骨板治疗肱骨近端骨折32例,男18例,女14例;年龄38～73岁,平均52岁。根据Neer分型,3部分骨折19例;4部分骨折13例。骨折复位后进行同种异体骨植入,通过骨折的大结节骨块下方进行骨折端植骨,锁定钢板螺钉固定。结果本组32例均获得8～16个月的随访,平均12个月,骨折8个月内全部愈合。按Neer肩关节功能评分标准评定:优19例,良9例,可4例,全组优良率87.5%。结论锁定钢板的螺钉锁扣于接骨板上,能够提高对肱骨近端粉碎骨折及伴有骨质疏松患者的固定效果,同种异体骨移植能有效消除Neer3部分、4部分肱骨近端骨折的骨缺损,有利于骨折断的愈合和牢靠固定,临床疗效满意,是一种有效的治疗方法。

Objective To discuss the treatment effect of locking compression plate （LCP） with bone transplantation for proximal humeral complicated fractures. Methods A retrospective study was done on 32 cases of proximal humeral fractures treated with LCP from April 2008 to June 2011.There were 18 male and 14 female,with age of 38-73 year （mean 52 year）.According to Neer classification, 19 cases were three part fractures;13 cases were four part fractures. Results 32 cases were followed up for 8-16 months,average 12 months,all fractures were union in 8 month.According to Neer shoulder score,the result was excellent in 19 cases, good in 9 and fair in 4,with excellent and good rate of 87.5%. Conclusion The screw of LCP can lock the plate so that the plate can firmly fixate the proximal humeral comminution fractures and osteoporosis bone.