PHILOS接骨板治疗47例Neer Ⅱ、Ⅲ型肱骨近端骨折的临床研究

Clinic study on 47 cases of Neer Ⅱ and Ⅲ proximal humeral fractures treated with proximal humeral internal locking system

目的探讨肱骨近端内固定锁定系统(PHILOS)治疗Neer Ⅱ、Ⅲ型肱骨近端骨折的临床疗效。方法回顾性分析2013年1月至2015年12月在该院因Neer Ⅱ、Ⅲ型肱骨近端骨折行PHILOS接骨板固定的47例患者的手术时间、术中出血量、住院时间、并发症、Constant评分等临床资料,并对患者的影像学资料进行评估。结果 47例患者均获随访,平均随访(19.2±9.6)个月,平均手术时间(95.6±43.1)min,平均术中出血量(108.0±41.6)mL,平均住院时间(11.3±3.2)d,并发症发生率为14.7%;Constant评分术前为(21.74±8.24)分,末次随访为(82.83±7.21)分,两者比较差异有统计学意义(t=-36.57,P<0.01)。结论 PHILOS接骨板是治疗Neer Ⅱ、Ⅲ型肱骨近端骨折的一种安全有效的方法。

Objective To investigate the clinic efficacy of proximal humeral internal locking system（PHILOS）in the treatment of Neer Ⅱ and Ⅲ proximal humeral fractures.Methods From January 2013 to December 2015,a total of 47 patients with Neer Ⅱ and Ⅲ proximal humeral fractures was treated with PHILOS fixation in our hospital.The operative time,blood loss in operation,hospital stay,complications,Constant scores and radiography films were retrospectively analyzed.Results All 47 patients were followed up for an average of（19.2±9.6）month.The average operative time,the level of average intraoperative blood loss,the mean hospitalization time and the complication rate were（95.6±43.1）min,（108±41.6）mL,（11.3±3.2）d and 14.7% respectively.The Constant score was improved from（21.74±8.24）preoperatively to（82.83±7.21）at the last follow-up,and the difference was statistically significant（t=-36.57,P〈0.01）.Conclusion Fixation with PHILOS is a safe and effective treatment for patients with Neer Ⅱ and Ⅲ proximal humeral fractures.