肱骨近端记忆接骨器的设计与临床应用

目的 探索肱骨头解剖颈至外科颈及肱骨近端干段骨折、骨不连的内固定新技术。方法 根据生物记忆材料镍钛合金性能与肱骨近端解剖生理特征，研制肱骨近端记忆接骨器（proximal humerus memory connector，PHMC），并临床治疗肱骨近端粉碎性骨折、畸形愈合、骨不连共22例。患者平均年龄41．7岁，平均随访18．5个月。结果 骨折骨性愈合时间平均3．6个月；骨不连骨性愈合时间平均4．5个月。骨愈合形式均呈骨板样骨替代，未见无序骨痂出现。PHMC术后弃用外固定，创伤反应期（7～12d）后，进行主动渐进性功能锻炼。肩关节功能按Michael Reese评分，平均88．5分。结论 PHMC能有效治疗肱骨解剖颈始至肱骨近端的各类型骨折与骨不连，亦为减少该部的假体关节置换探索出了新路。

Design and clinical applications of proximal humerus memory connector

Objective To explore a new method to treat the fracture and nonunion of the region from anatomical neck to the diaphysis part of the proximal humerus. Methods According to the mechanical character of biomemory material Nitional and the anatomicophysiological character of proximal humems, a new device called proximal humerus memory connector (PHMC) was designed and employed to treat the comminuted fracture,malunion and nonunion of proximal humerus in 22 cases that were with average age of 41.7 years and followed up for average 18.5 months. Results The bone healing time was average 3.6 months for the fractured cases and 4.5 months for the nonunion cases.The healing style was characterized by plate bone substitution, with no disordering callus. After internal fixation by PHMC, external fixation was beyond need and the patients began to do active exercises 7-12 days after operation. The function of the shoulder joint was scored for average 88.5 scores according to Michael Reese criteria. Conclusions PHMC is an efficacious method to treat every type of fractures and nonunions in the region from anatomical neck to the diaphysis part of the humerus and thus provides a new way to reduce prostheses displacement in such region.