外固定支架在肱骨近端骨折切开复位内固定中的临时应用价值

发布时间：2018-04-13 15:15

本文选题：肱骨骨折 + 近端:骨折固定术　；参考：《苏州大学》2015年硕士论文

【摘要】：目的探讨外固定支架在肱骨近端骨折切开复位内固定中的临时应用价值。方法自2012年7月至2014年1月采用三角肌胸大肌间隙入路切开复位钢板内固定治疗肱骨近端骨折22例,男8例,女14例;年龄33~76岁,平均52岁;左侧13例,右侧9例。采用Neer骨折分类法,Neer二部分骨折5例,均为外科颈骨折:Neer三部分骨折13例,其中合并肩关节前脱位3例;Neer四部分骨折4例,其中合并肩关节前脱位1例。术中使用单边外固定支架临时辅助复位固定,采用肱骨近端锁定钢板内固定系统(PHILOS,瑞士Synthes公司)内固定。术后测量肱骨颈干角,采用Constant肩关节功能评分评定肩关节功能。结果随访时间为8~21个月,平均12个月,术后X线评估肱骨颈干角为133.3°±6.9°。发生肱骨头坏死3例,内翻畸形1例。Constant肩关节功能评为82.9±8.1分,优良17例,占77%,可为4例,占18%,差为1例,占5%。其中Neer二部分骨折优良率为100%,无肱骨头坏死;Neer三部分骨折优良率为77%,无差的病例,肱骨头坏死发生率为15%;Neer四部分骨折优良率为50%,差为25%,肱骨头坏死率为25%。结论在肱骨近端骨折切复内固定中临时应用单边外固定支架辅助复位固定效果肯定,术后早期合理的功能锻炼,可取得满意的治疗结果。
[Abstract]:Objective to evaluate the application of external fixator in open reduction and internal fixation of proximal humerus fracture.Methods from July 2012 to January 2014, 22 cases of proximal humeral fractures were treated by open reduction and internal fixation with plate through the approach of deltoid muscle major pectoralis space, including 8 males and 14 females, aged 3376 years (mean 52 years), left 13 cases, right 9 cases.Neer fracture classification method was used in 5 cases, all of which were divided into three parts of surgical neck fracture: 13 cases, including 3 cases with anterior dislocation of shoulder joint and 4 cases with four parts fracture of Neer, among which 1 case was complicated with anterior dislocation of shoulder joint.Unilateral external fixator was used for temporary auxiliary reduction and fixation with proximal humerus locking plate fixation system (Synthes, Switzerland).The humeral neck shaft angle was measured and the shoulder function was evaluated by Constant.Results the follow-up time ranged from 8 to 21 months (mean 12 months). The angle of humeral neck shaft was evaluated by X ray examination (133.3 掳卤6.9 掳).There were 3 cases of humeral head necrosis, 1 case of varus deformity. The function of constant shoulder joint was evaluated as 82.9 卤8.1 points, 17 cases were excellent (77%), 4 cases were fair, 18 cases were inferior, 1 case was inferior, and 5 cases were inferior.The excellent and good rate of the second part fracture of Neer was 100, the excellent and good rate of the three parts of the fracture without necrosis of the brachial head was 77. In the case of no bad, the excellent and good rate of the four parts of the fracture was 50, the difference was 25, and the necrosis rate of the head of the brachial head was 255.The rate of necrosis of the brachial head was 25.5%.Conclusion the effect of unilateral external fixator in internal fixation of proximal humerus fracture is satisfactory.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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