老年肱骨近端骨折内侧柱重建的研究进展

肱骨近端内侧柱是肱骨头内下方的一段连续骨皮质区域,该区域自被提出以来,越来越受到临床和科研的重视.研究发现它有增加内固定的稳定性,维持肱骨头高度,防止内翻,以及降低螺钉穿出的风险等作用,生物力学研究也表明,内侧柱在增加锁定钢板的刚度、抗扭转力、抗剪切力等方面有突出的表现.虽然有诸多好处,但它的概念、具体区域尚未有统一的...

Progress in the research of medial column reconstruction of proximal humerus fractures in the elderly

The proximal medial column of the humerus is a continuous cortical region in the inner and lower part of the humerus head,which has attracted more and more attention in clinical and scientific research since it was proposed. It has been shown to increase the stability of internal fixation,maintain the height of the humeral head to prevent varus,and reduce the risk of screw penetration. Biomechanical studies have also shown that the medial column has an outstanding performance in increasing the stiffness,torsion resistance,and shear resistance of the locking plate. Although it has many benefits,there is no unified definition of its concept and specific region,and the existing classification does not include the medial column,therefore more researches are required to provide supporting information. The methods of medial column reconstruction mainly include locking plate combined with talus screw,locking plate combined with bone grafting,internal and external double plate combined support,locking plate combined with bone cement,and humeral cage. These methods have their own characteristics,however they will increase the cost of surgery and bring new complications. How to determine the best way of reconstruction is one of the focuses of future research. In this review,the concept of the proximal medial humerus column,the role of maintaining internal fixation,the role of biomechanics and the reconstruction methods are reviewed.