锁定钢板治疗老年性肱骨近端骨折52例疗效分析

发布时间：2018-05-12 19:54

本文选题：肱骨近端 + 骨折　；参考：《中国矫形外科杂志》2017年14期

【摘要】：[目的]探讨锁定钢板治疗老年性肱骨近端骨折的临床疗效。[方法]回顾性分析2011年1月~2014年1月52例肱骨近端骨折患者资料,男16例,女36例,年龄60~88岁,平均(67±6.8)岁;骨折按Neer分类:2部分骨折28例,3部分骨折18例,4部分骨折6例。采用经胸大肌三角肌间隙入路,锁定钢板固定。术后采用UCLA评分评价肩关节功能情况;影像学评价骨折愈合、内置物位置及并发症情况。[结果]患者均获得12~24个月(平均12个月)随访。UCLA肩关节功能评分:优良36例,可10例,差6例,优良率69.2%。并发症发生15例次,其中肩关节撞击3例、螺钉穿出3例、内翻畸形6例、螺钉松动1例及骨不连各1例、肱骨头吸收伴坏死1例。[结论]锁定钢板内固定是治疗肱骨近端骨折的有效方法,但并发症仍比较高,术中应注意保护肱骨头周围血运、骨折良好复位、内置物合适的放置等可减少并发症的发生。
[Abstract]:Objective to investigate the clinical effect of locking plate in the treatment of senile proximal humerus fracture. [methods] from January 2011 to January 2014, 52 patients with proximal humeral fractures were retrospectively analyzed. There were 16 males and 36 females, aged 60 to 88 years, with an average age of 67 卤6.8 years, and 18 patients with 4 parts fractures were divided into two parts according to Neer classification. Through the deltoid space of pectoralis major muscle approach, locking plate fixation. UCLA score was used to evaluate the function of shoulder joint, and imaging was used to evaluate fracture healing, location of implants and complications. [results] all the patients were followed up for 12 ~ 24 months (mean 12 months). UCLA shoulder function score was excellent in 36 cases, fair in 10 cases, poor in 6 cases. The excellent and good rate was 69.2%. The complications occurred in 15 cases, including shoulder impact in 3 cases, screw perforation in 3 cases, varus deformity in 6 cases, screw loosening in 1 case and nonunion in 1 case, humeral head resorption with necrosis in 1 case. [conclusion] locking plate internal fixation is an effective method for the treatment of proximal humerus fracture, but the complications are still high. During the operation, attention should be paid to the protection of blood circulation around the humerus head, good reduction of the fracture and proper placement of the internal material to reduce the incidence of complications.
【作者单位】：南通大学附属吴江第一人民医院骨科;
【分类号】：R687.32

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