应用异体腓骨结构性植骨结合钢板螺钉内固定治疗肱骨近端骨折的疗效

Effects of treatment of proximal humeral fractures with allograft structural bone grafting combined with plate and screw fixation

目的探讨应用异体腓骨结构性植骨结合钢板螺钉内固定治疗肱骨近端骨折的疗效。方法回顾性分析2014年7月至2017年9月在首都医科大学附属北京朝阳医院骨科应用异体腓骨结构性植骨结合钢板螺钉内固定治疗的11例肱骨近端骨折患者的病历资料。其中,男4例,女7例;平均年龄68(47~81)岁。Neer分型:3部分骨折8例,4部分骨折3例。采用Constant-Murley肩关节评分量表(CMS)对患者的肢体功能进行评定,并评估治疗效果及并发症发生情况。结果术后所有患者均获得随访,平均随访时间14.6(13~17)个月。所有患者均达到骨性愈合,未见内固定失效及骨折移位。CMS评分:优3例,良7例,一般1例。随访期间,有1例患者发生伤口感染。结论应用异体腓骨结构性植骨结合钢板螺钉内固定治疗肱骨近端骨折能提供更牢固的稳定性,满足患者早期功能锻炼需求,可提高预后效果。

Objective To investigate the effects of allograft structural bone grafting combined with plate and screw internal fixation in the treatment of proximal humeral fractures. Methods From July 2014 to September 2017, 11 patients with proximal humeral fracture who were treated with fibula allograft structural bone grafting and plate and screw internal fixation in the Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University were analyzed retrospectively. Among them, there were 4 males and 7 females with an average age of 68(47-81) years. Neer type 3 fractures in 8 cases, type 4 fractures in 3 cases. The limb function of the patients was assessed by constant Murley shoulder joint score scale(CMS). The therapeutic effect and complications were evaluated. Results All patients were followed up with an average of 14.6(13-17) months. Bone healing was achieved in all patients without internal fixation failure or fracture displacement. The CMS score: excellent in 3 cases, good in 7 cases, average in 1 case. During follow-up, 1 patient developed wound infection. Conclusion The application of fibula allogeneic structural bone grafting combined with plate and screw internal fixation for proximal humerus fracture can provide more stable, meet the needs of patients’ early functional exercise, and improve the prognosis.