18例Ⅳ型肱骨外科颈骨折的手术体会

Operative Study of Humerus Surgical Neck Fracture(Neer Ⅳ) in 18 cases

目的探讨NeerⅣ型肱骨外科颈骨折的手术方法及临床疗效。方法应用肱骨近端解剖型锁定钢板结合植骨治疗NeerⅣ型肱骨外科颈骨折患者18例，研究内固定物的使用，骨折复位、植骨等相关问题。结果18例患者均获6—22个月随访，平均10个月，均骨性愈合，愈合时间8-16周，平均11周。根据Neer评分标准进行肩关节评分，功能恢复优10例，良6例，可1例，差1例，优良率88．9％。结论肱骨近端解剖型锁定钢板结合植骨治疗NeerIV型肱骨外科颈骨折，固定牢固，并发症少，骨折愈合快，可早期功能锻炼，肩关节功能恢复良好。

Objective To explore the operative method and the clinical effect of humerus surgical neck fracture （neer Ⅳ）. Methods 18 cases of humerus surgical neck fracture（ neer Ⅳ） were treated by locking proximal humeral anatomical plate combining bone grafting, The use of internal fixation, fracture reduction, bone grafting and other related issues. Results All 18 cases were followed-up for 6 to 24 months（ an average of 10 months） and all the fractures got bone union within 8 to 16 weeks（ an average of 11 weeks）. According to Neer scoring system, 10 cases were excellent, 6 good, 1 fair and 1 poor. The excellent and good rate was 88. 9%. Conclusion Treatment of humerus surgical neck fracture （ neer Ⅳ） with locking proximal humeral anatomical plate combining bone grafting has stable internal fixation and fewer complications, fracture healing, to early exercise and a good recover of shoulder function.