有限切开技术锁定钢板治疗骨质疏松性肱骨近端骨折的疗效分析

The clinical outcome of using the proximal humeral locking plate for osteoporotic proximal humeral fractures

目的评估采用有限切开技术锁定钢板治疗骨质疏松性肱骨近端骨折的疗效。方法回顾性研究2008年1月-2011年6月我院采用有限切开技术锁定钢板治疗骨质疏松性肱骨近端骨折57例,其中男17例,女40例,年龄61~88岁,平均72.6岁。按Neer分类,二部分骨折16例,三部分骨折29例,四部分骨折12例。术后采用Constant-Murley（CMS）评分进行随访并评估患者的肩关节功能。结果 54例获随访,3例失访,随访时间12~38个月,平均25.2个月。所有患者骨折均骨性愈合,骨折愈合时间12~20周,平均16.1周。术后6月CMS评分为68.7±8.4,术后12月CMS评分为85.1±7.6。结论采用有限切开技术锁定钢板治疗骨质疏松性肱骨近端骨折是一种有效的治疗方法,具有手术创伤小,复位确切,固定可靠,并发症少,功能恢复满意等优点。

【Objective】 To evaluate the outcome of using minimal invasive technique with proximal humeral locking plate in treatment of osteoporotic proximal humeral fracture.【Methods】In this retrospective study,57 patients with osteoporotic proximal humeral fractures were treated by open reduction and internal fixation with proximal humeral locking plate.There were 40 women and 17 men with a mean age of 72.6 years（61 to 88）.According to Neer classification,there were 16 two-part cases,29 three-part cases and 12 four-part cases respectively.The outcomes were assessed with Constant-Murley Score（CMS） scoring systems.【Resluts】Fifty-four patients were followed up for the average 25.2（12 to 38） months,three patients lost follow up.All the patients’ fracture got union at 16.1（12 to 20） weeks postoperatively.Six months post operation,the mean Constant-Murley score was 68.7±8.4.Twelve months post operation,the mean Constant-Murley score was 85.1±7.6.【Conclusion】It is a good treatment for the patients of proximal humeral fracture or osteoporosis using minimal invasive technique with philos locking plate.this technique can provides stable fixation with less complication.