微创钢板固定治疗老年骨质疏松性肱骨近端骨折

目的 探讨微创钢板固定(minimally invasive plate osteosynthesis,MIPO)技术治疗老年骨质疏松性肱骨近端骨折的疗效.方法 2003年6月-2006年6月,采用微创钢板内固定治疗38例老年骨质疏松性肱骨近端三、四部分骨折患者,并对术后肩关节功能及并发症进行分析.结果 术后随访时间为15～50个月(平均32.1个月),骨折固定后无再次移位、内固定物松动断裂及螺钉进入关节间隙、肱骨头缺血性坏死等并发症.38例骨折全部获得骨性愈合,愈合时间为14～27周(平均18.3周).肩关节功能采用Neer评分:优26例,良8例,中4例;优良率为89.5%.结论 采用MIPO技术治疗老年骨质疏松性肱骨近端骨折,术后并发症少,疗效满意.

LPHP combined with MIPO techniques for treatment of proximal humeral fractures in elderly osteoporotic patients.

Objective A prospective study was conducted to evaluate the efficacy of LPHP combined with MIPO techniques for treatment of proximal humeral fractures in elderly osteoporotic pailents.Melhods Thirty-eight elderly patients aged from 63 to 86 years with part-three and part-four fractures of the proximal humerus Were managed with the above-mentioned method between June 2003 to June 2006.Postoperative shoulder function and complications were evaluated and analyzed.Results The follow up period of the 38 cases ranged from 15 to 50 months(average 32.1 months).There was no infection,no avasculax necrosis of the humeral head,and no incidence of implant failure.Bone union was achieved in all the cases,with the mean healing period of 38 cases ranged from 14 to 27 weeks(average 18.3 weeks).According to Neer scoring,excellent in 26 cases,good in 8 cases,and fair in 4 cases.The excellent and good result rate was 89.5%. Conclusion LPHP combined with MIPO techniques is a satisfactory and effective method for treatment of proximal humeral osteoporotic fractures.