采用PHILOS钢板微创治疗肱骨近端骨折

目的探讨应用微创钢板接骨术(minimally invasive plate osteosynthesis,MIPO)结合PHILOS锁定钢板治疗肱骨近端骨折的临床意义和方法。方法 2008年8月~2010年7月,采用PHILOS钢板微创治疗肱骨近端骨折39例,其中男16例,女23例;年龄45~86岁,平均64.5岁。骨折采用Neer分型,其中二部分骨折12例,三部分骨折22例,四部分骨折5例。结果所有患者切口均一期愈合。35例获得6~18月(平均10.5个月)随访,4例失访。骨折全部愈合,愈合时间为术后10~15周,平均12周。无神经血管损伤、骨折不愈合和内固定松动、断裂等并发症。肩关节功能按Constant-Murley肩关节评分标准评价:优22例,良11例,可2例,优良率约94%。结论采用PHILOS钢板微创治疗肱骨近端骨折,具有创伤小、固定牢靠、并发症少、满意率高等优点,是治疗肱骨近端骨折的一种理想方法。

Application MIPO technical with PHILOS treatment of 39 patients with proximal humerus fractures

Objective To explore the clinical significance and methods of minimally invasive plate osteosynthesis （MIPO） with PHILOS plate in the treatment of proximal humeral fractures. Methods From August 2008 to July 2010, 39 patients were treated with MIPO combined PH1LOS plate.including 16 males and 23 females aged 45 to 86 years old （average 64.5 years old）. There were 12 patients with two-part fractures, 22 with three-part fractures, 5 with four-part fractures according to Neer classification. Results All incisions healed by first intension, and 35 cases were followed up for 6 to 18 months （average 10.5 months）, and four were lost to follow-up. All patients achieved bone union, and the mean healing time was 12weeks （range 10to 15weeks）. No such complications as neurovascular injury, fractureunhealing, internal fixation loosening and fracture occurred. According to the scoring systems of Constant-Murley, 22 patients had an excellent functional result, ll patients had an good functional result. 2 patients had an moderate functional result. The rate of excellent and good was 94%. Conclusion MIPO technique using PHILOS plate is an effective method ofin- temal fixation for treating fractures ofproximal humeral. It has the advantages ofless injury, solid fixation, minorcom- plications, and high satisfactory rate.