钢板增强内固定治疗肱骨近端粉碎性骨折的研究进展

肱骨近端骨折是老年人群最常见的损伤之一,随着社会人口老龄化,肱骨近端骨折发生率日益上升1-3].肱骨近端骨折中约20%为移位明显的不稳定骨折.切开复位内固定是治疗肱骨近端不稳定骨折的主要方法,以肱骨近端锁定内固定系统(proximal humerus internal locking system,PHILOS)为代表的锁定钢板具有成角稳定、解剖设计等优点,是目前首选的固定材料4-11].但临床研究发现手术治疗的并发症高达50%,包括肱骨头缺血坏死、骨折不愈合或畸形愈合、螺钉切出等12-14].骨折严重粉碎、骨质疏松和内侧支撑不足是并发症的主要危险因素15-18],增强肱骨近端骨内支撑有助于提高手术治疗稳定和防止并发症.肱骨距螺钉、骨水泥填充、异体骨支撑、可膨胀钛网以及特殊钢板等都是目前最常用的肱骨近端骨折增强内固定手段.笔者拟对该方面的研究进展做一综述.

Reinforced plate fixation for proximal humeral fractures

Proximal humeral fracture,one of the most common injuries in the elderly,shows a gradual increase along with the aging population.Surgery is favored,the complication rate is high though.Reinforced plate fixation helps to prevent complications following comminuted fractures,osteoporosis,and insufficient internal support.Calcar screw,bone cement,allograft,expandable titanium mesh,and special plate are frequently applied in the treatment of proximal humeral fractures.This paper reviews the research progress of reinforced plate fixation for references.