同种异体腓骨移植联合锁定钢板治疗肱骨近端骨折的研究进展

Research progress in treatment of proximal humeral fracture with fibular allograft and locking plate

目的对同种异体腓骨移植联合锁定钢板治疗肱骨近端骨折的研究进展进行综述。方法广泛查阅国内外同种异体腓骨移植联合锁定钢板治疗肱骨近端骨折的相关文献,从生物力学、影像学预后以及临床预后等多个方面进行总结分析。结果与单纯应用锁定钢板相比,同种异体腓骨移植联合锁定钢板治疗肱骨近端骨折,可以对肱骨近端提供有效的内侧支撑,并增加内固定系统强度;同时可以更好地维持术后肱骨颈干角以及肱骨头高度,恢复更好的术后肩关节活动度及肩关节功能,并且不会增加相关并发症发生风险。结论同种异体腓骨移植联合锁定钢板可能成为一种新的有效的治疗肱骨近端骨折手术方式,但目前中远期随访结果报道有限,移植腓骨的长期预后仍然不确定,同时该治疗方式可能引起的长期潜在不良反应仍不够明确。

Objective To review the research progress in the treatment of proximal humeral fractures with fibular allograft and locking plate.Methods The literature about the treatment of proximal humeral fractures with fibular allograft and locking plate was reviewed and analyzed from the aspects such as the biomechanics,imaging prognosis,and clinical prognosis.Results Fibular allograft and locking plate can provide effective medial support for proximal humeral fracture and increase the strength of internal fixation system.Compared with locking plate,fibular allograft combined with locking plate can maintain better humeral neck-shaft angle and the humeral head height after operation in the treatment of proximal humeral fractures,and has better shoulder mobility and shoulder joint function,and does not increase the risk of complications.Conclusion Fibular allograft combined with locking plate may be a new and effective treatment for proximal humeral fractures.However,the long-term follow-up results are insufficient,the final outcome of fibula is uncertain,and the long-term potential adverse reactions caused by this treatment are still indefinite.