摘要
目的探讨采用PHILOS锁定钢板治疗肱骨近端粉碎性骨折的临床疗效。方法收集2010年1月至2012年6月应用PHILOS锁定钢板治疗16例肱骨近端骨折患者，通过影像学资料、Constant-Murley评分（Constant-Murley score，CMS）及美国肩肘外科医师（ American shoulder and elbow surgeons, ASES） 评分对患者骨折愈合情况、肩关节功能及并发症等进行评估。结果16例患者均获随访，平均随访时间17（6～25）个月。16例（100％）患者获得骨性愈合，14例患者基本获得解剖复位（87．5％），1例（6．2％）患者术后肩关节轻度疼痛，1例（6．2％）患者术后肩关节功能严重障碍。所有病例无钢板螺钉断裂、肱骨头缺血性坏死发生；平均ASES评分为80．5（40～96）分，平均Constant评分为72．4（32-93）分；其中患肢肩关节功能优12例（75．0％）、良3例（18．8％）、差1例（6．2％）。结论采用PHILOS锁定钢板治疗肱骨近端粉碎型骨折，尤其对老年性骨质疏松患者，不仅可提供稳定的骨折固定，而且能进行早期功能锻炼，从而取得较好的疗效。
Objective To evaluate the clinical efficiency of the comminuted proximal humerus fractures treated with the PHILOS locking plate. Methods A total of 16 patients suffering from eomminuted proximal humerus fractures receiving PHILOS locking plate in our department from January 2010 to June 2012 were enrolled in this study. They were followed up over a mean period of 17 months （ranging from 6 to 25 months）. The final follow-up included anteroposterior and lateral X-ray films, the Constant Score （CMS） and the American Shoulder and Elbow Surgeons （ASES） score. Results At the final follow-up, union was observed in 16 patients （100%）, and 14 fractures （87.5%） were healed in good anatomical position by radio- graphy. One patient suffered from slight shoulder joint pain. Clinical visits and review of medical records showed one patient had painful and frozen shoulder. There was no evidence of screw penetration into the joint primarily or secondarily and no evidence of avascular necrosis （AVN） as well as screw cutout. The mean ASES score was 80.5 （ ranging from 40 to 96）, and the mean CMS was 72.4 （ ranging from 32 to 93 ）. The results were excellent or good in 12 patients （75.0%） , moderate in 3 patients （ 18.7% ） , and poor in 1 patient （6.2%）. Conclusion PHILOS locking plate in the treatment of comminuted proximal humerus fracture, especially for patients with senile osteoporosis, not only provides stable fixation, but also guarantees early functional exercise, so as to obtain better healing effect.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2013年第19期2101-2104,共4页
Journal of Third Military Medical University
