组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2011, Vol. 7 ›› Issue (1): 30-33.doi: 10.3969/j.issn.1673-0364.2011.01.008

• 论著 • 上一篇    下一篇

切开复位锁定钢板内固定治疗肱骨近端骨折

章暐，邹剑，张长青   

  1. 上海交通大学医学院附属第六人民医院骨科
  • 发布日期:2020-07-23

The Prospective Study of Open Reduction and Internal Fixation of Proximal Humeral Fractures Using Locking Proximal Humerus Plate

ZHANG Wei,ZOU Jian,ZHANG Changqing   

  1. Department of Orthopaedics,Shanghai Sixth People′s Hospital,Jiaotong University School of Medicine,Shanghai 200233,China.
  • Published:2020-07-23

摘要： 目的评价锁定钢板治疗肱骨近端骨折的临床效果及并发症。方法采用锁定钢板对骨折进行常规手术治疗。术后3、6、12个月对患者进行随访。随访内容包括疼痛、生活情况、力量及Constant评分,并与对侧肩关节进行对照。每次随访时,拍摄肩关节前后位片及"Y"位片,评价骨折愈合情况及可能存在的并发症。结果本组共106例肱骨近端骨折患者。其中,使用5孔钢板95例(90%),其余类型钢板11例(10%)。术后随访发现,患者受伤肩的活动度有明显的提高(P<0.05)。术后12个月,肩关节前伸可达(132°±35°),外展(122°±39°),外旋(45°±23°),内旋(77°±21°);患肩的Constant评分为(70.6±13.7),达到健侧(83.0±8.0)的(85.1%±14.0%),并随时间推移有明显提高(P<0.05)。在完成随访的93个患者中,25人(27%)出现了34例并发症,其中的18例(53%)并发症发生在术后3个月内,而22例(65%)并发症是因手术操作导致的。结论采用锁定钢板治疗不稳定性及老年性肱骨近端骨折有较好的临床效果。尽管也有并发症的发生,但大多是由手术操作造成的,是可以避免的。

关键词: 内固定, 肱骨近端, 锁定钢板

Abstract: Objective To evaluate the functional outcome and the complication rate after open reduction and internal fixation of proximal humeral fractures using locking proximal humeral plate.Methods One hundred and six patients(mean age,62.9±15.7 years) with acute proximal humeral fracture were managed with open reduction and internal fixation using locking proximal humeral plate.With the three-month,six-month,and one-year follow-up,all patients were assessed with pain,shoulder mobility,complications,strength and the Constant score,comparing with the contralateral side.Results Among all the 106 cases,95 cases used 5 hole plate,11 cases used other types of plate.After 12 months of follow-up,matoration of injured shoulder enhanced obviously(P<0.05).Shoulder protraction can reach(132 ° ± 35 °);outward(122 ° ± 39 °);out-rotation(45 ° ± 23 °);intorsion(77 ° ± 21 °).One year postoperation,the Constant score was(70.6±13.7),(85.1%±14.0%) of the contralateral side(83.0±8.0).In addition,the score enhanced as the follow-up time went on(P<0.05).Among the 93 patients who finished the follow-up,25(27%) patients appeared 34 complications.18 complications(53%) happened in 3 months post-operation.22 complications(65%) were related to incorrect surgical technique.Conclusion Surgical treatment of displaced proximal humeral fractures using locking proximal humeral plate can lead to a good functional outcome and most of the complications were related to incorrect surgical technique.

Key words: Internal fixation, Proximal humerus, Locking plate

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