锁定接骨板治疗老年肱骨近端骨折

目的 探讨肱骨近端锁定接骨板(LPHP)治疗肱骨近端骨折的临床疗效。方法 采PHP治疗29例肱骨近端骨折，按Neer分类法，二部分骨折11例；三部分骨折12例；四部分骨折6例。结果 平均愈合时间7．4周(6～12周)：按照Constant评分标准，功能优18例，良为8例，中为3例，优良率为89．6％。结论 肱骨近端锁定接骨板治疗眩骨近端骨折手术简单、固定可靠、并发症少、骨折愈合率高特别是老年骨质疏松患者首选治疗方法。     

锁定肱骨近端接骨板治疗肱骨近端骨折

目的探讨锁定肱骨近端接骨板治疗肱骨近端骨折的临床价值：方法采用切开复位AO锁定肱骨近端接骨板(LPHP)内固定治疗肱骨近端骨折12例。结果所有患随访3～13个月，平均7．5个月。临床疗效评估：优7例，良3例，进步2例，优良率为83．3％。结论LPHP具有固定可靠、减少软组织损伤、保护血运、利于关节囊和肩袖修复、有助于骨折愈合和肩关节功能恢复的特点，值得提倡。     

锁定接骨板治疗老年肱骨近端骨折

目的探讨肱骨近端锁定接骨板内固定治疗老年肱骨近端骨折的疗效。方法2002年1月～2004年1月对35例老年肱骨近端骨折予以锁定接骨板内固定治疗,术后早期功能锻炼。结果术后所有患者平均随访13.2个月,骨折愈合时间平均8.3周(7～12周),1例肱骨头缺血性坏死。按Constant评分标准,平均81.4分(39～95分),其中优22例,良8例,中4例,差1例,优良率85.7%。结论肱骨近端锁定接骨板对于骨质疏松的老年肱骨近端骨折是一种安全有效的治疗方法。     

锁定接骨板治疗肱骨近端骨折

目的探讨肱骨近端锁定接骨板治疗肱骨近端骨折的临床疗效。方法59例肱骨近端骨折,其中男32例,女27例患者平均年龄50.5岁(22～82岁)。按Neer分类法,二部分骨折23例;三部分骨折24例;四部分骨折12例。结果X线片观察骨折愈合时间7.4周(6～12周)。按照Constant评分标准,功能优34例,良19例,中6例,优良率为89.8%。结论肱骨近端锁定接骨板治疗肱骨近端骨折手术简单、微创、固定可靠、并发症少、骨折愈合率高,别是老年骨质疏松患者首选治疗方法。     

锁定接骨板治疗肱骨近端骨折

<正>2010年2月~2013年10月,我科采用肱骨近端锁定接骨板治疗肱骨近端骨折38例,疗效显著,报道如下。1材料与方法1.1病例资料本组38例,男16例,女22例,年龄48~88岁。均为闭合骨折。依据Neer分型:两部分骨折9例,三部分骨折17例,四部分骨折12例。     

锁定接骨板治疗老年肱骨近端骨折的近期疗效

目的 探讨锁定接骨板治疗老年肱骨近端骨折的近期疗效.方法 采用切开复位锁定接骨板内固定治疗26例老年肱骨近端骨折患者.结果 26例均获随访,时间6个月～2年.患者全部获得骨性愈合.未出现切口感染、骨不连及内固定物断裂等并发症.肩关节功能按照Neer评分标准:优17例,良7例,可2例.结论 肱骨近端锁定接骨板治疗老年肱骨近端骨折,损伤小、固定可靠,可提供早期功能锻炼、术后功能恢复好,近期疗效满意.     

肱骨近端锁定接骨板治疗肱骨近端粉碎性骨折

目的 探讨应用肱骨近端锁定接骨板(locking proximal humerus plate,LPHP)内固定治疗肱骨近端粉碎性骨折的可行性和疗效.方法 对2004年9月至2007年9月收治并获得随访的18例肱骨近端骨折进行回顾性分析,其中男7例,女11例,年龄25～79岁,平均52.8岁.所有骨折均按Neer分型:二部分骨折4例,三部分骨折6例,四部分骨折8例,其中骨质疏松7例.手术经三角肌、胸大肌间隙入路,采用肱骨近端锁定接骨板对骨折进行固定,对其中6例存在严重骨缺损患者进行自体骨植骨.结果 随访8～24个月,平均12.5个月,骨折均愈合.采用Neer肩关节功能评分标准评定:优6例,良7例,中3例,差2例,优良率为72.2%.合并内翻畸形1例,肱骨头缺血性坏死2例(术后1年行人工肱骨头置换术),肩关节创伤性关节炎2例,骨折延迟愈合1例.结论 肱骨近端锁定接骨板内固定是一种有效的适宜于肱骨近端粉碎性骨折的治疗方法 ,既能实现对骨折断端的稳固固定作用,又避免了对骨块附着软组织和骨膜的过多剥离,可有效地遏制肱骨头的缺血性坏死.     

锁定接骨板治疗肱骨近端复杂骨折

目的探讨肱骨近端锁定接骨板（LPHP）治疗肱骨近端复杂骨折的临床疗效。方法回顾分析本院2003年1月至2005年10月采取LPHP治疗31例肱骨近端复杂骨折。按Neer分型，3部分骨折22例；4部分骨折9例。结果31例经5～13月随访．无1例发生内固定松动、断裂，全部骨折均愈合。肩关节功能按照Constant评分标准，功能优9例，良18例，中4例，优良率87．1％。结论LPHP治疗肱骨近端复杂骨折固定可靠、骨折愈合率高、可行早期功能锻炼，功能恢复好。     

锁定接骨板治疗老年肱骨近端复杂骨折

目的探讨肱骨近端锁定接骨板治疗老年肱骨近端复杂骨折的临床疗效。方法采用肱骨近端锁定接骨板治疗27例肱骨近端骨折。根据Neer分类,三部分骨折22例,四部分骨折5例,所有病例均应用肱骨近端锁定接骨板治疗,术后严格功能锻炼。结果本组病例骨折平均愈合时间7．1周（6-12周）。根据Constant评分标准评定平均分为88．2分,其中功能优17例,良8例,中2例,优良率为92．6％。结论肱骨近端锁定接骨板治疗老年骨质疏松患者肱骨近端骨折具有固定可靠、并发症少、手术简单、骨折愈合快等优点。     

肱骨近端锁定接骨板结合功能锻炼治疗老年肱骨近端骨折

目的:探讨肱骨近端锁定接骨板(LPHP)结合早期功能锻炼治疗老年肱骨近端骨折的方法和疗效。方法:采用LPHP治疗老年肱骨近端骨折39例,其中二部分骨折12例,三部分骨折19例,四部分骨折8例。术后均加强早期功能锻炼。结果:随访10～15个月(平均12个月)。患肩功能按Neer肩关节评分系统进行评价,功能优20例,良15例,可4例,优良率为89.7%。结论:LPHP对老年肱骨近端骨折具有坚强固定、手术简单、骨折愈合快、合并症少等特点,结合早期功能锻炼,可获得良好疗效。     

锁定加压钢板治疗肱骨近端骨折

2005年3月～2008年3月,我科应用锁定加压钢板内固定治疗肱骨近端骨折25例,疗效满意。1材料与方法1.1病例资料本组25例,男20例,女5例,年龄17～68岁。左侧13例,右侧12例。按Neer分型：二部分骨折16     

Locking plate fixation for proximal humerus fractures

Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.     

锁定钢板治疗肱骨近端骨折

2009年1月～2011年5月,我科采用肱骨近端锁定加压钢板治疗64例肱骨近端移位骨折患者,效果良好,报道如下。1材料与方法1.1病例资料本组64例,男38例,女26例,年龄18～75岁。左侧27例,     

锁定加压接骨板内固定治疗肱骨近端骨折

目的探讨肱骨近端锁定接骨板内固定治疗中老年肱骨近端粉碎性骨折的临床疗效。方法自2005年5—2007年1月，应用肱骨近端锁定接骨板内固定治疗肱骨近端粉碎性骨折12例，其中男4例，女8例；左侧5例，右侧7例；年龄60-75岁，平均66岁。根据Neer分类：二部分骨折7例，三部分骨折4例，四部分骨折1例，均为闭合性新鲜骨质疏松性骨折。采用三角肌、胸大肌间隙入路，9例行自体骨植骨术。结果12例均得到随访，随访时间4-18个月，平均10个月。所有骨折均愈合，平均愈合时间12周，根据Constant评分，优5例，良5例，中2例，优良率83．3％。结论肱骨近端锁定接骨板内固定治疗中老年肱骨近端粉碎性骨折具有固定可靠、退钉率低、并发症少等优点；必要时植骨，可提高骨折愈合率，特别适用于骨质疏松的肱骨近端粉碎性骨折。     

锁定钢板治疗老年肱骨近端骨折

<正>2005年3月~2010年12月,我院应用锁定钢板治疗36例老年肱骨近端骨折患者,取得了良好疗效,报道如下。1材料与方法1.1病例资料本组36例,男16例,女20例,年龄60~85岁。左侧20例,右侧16例。闭合骨折33例,开放骨折3例。按Neer分型:二部分骨折8例,三部分骨折24例,四部分骨折4例。均为新鲜骨折。合并心、脑、肝、肾等脏器疾     

Locking plate osteosynthesis for fractures of the proximal humerus

BACKGROUND: Beside non-operative treatment the therapeutic options for proximal fractures of the humerus range from closed reduction and transcutaneous K-wiring to total joint replacement. While the first is regarded as minimally invasive the latter is a rather complex intervention. Plating has been disregarded as combining the disadvantages of an extended approach with too often insufficient primary postoperative stability. The new concept of completely angle stabile plate fixation aims on improving this balance by achieving greater stability even in osteoporotic fractures. STUDY DESIGN: This retrospective analysis compares 51 patients treated with a partially (39) or complete (12) angle stabile humeral plate (K?nigseeplatte in two modifications) with 32 patients treated according to surgeons preference with conventional plates or K-wires. Both groups were treated at the same department during the same period and did not differ in their age nor sex distribution. RESULTS: Until discharge there were 2 secondary dislocations discovered in group 1 and 7 in group 2. The follow-up rate was 47.1 % (24/51) in group 1 and 46.8 % (15/32) in group 2. The time interval from surgery amounted to 1.2 (0.66-1.75) and 1.0 (0.72-1.32) years respectively. Among the patients available for follow-up in group 1 8 had sustained a two-, 8 a three- and 3 a four-part fracture according to Neer's classification. In group two there were accordingly 2 two-, 8 three- and 1 four part fractures. Clinical assessment using Neer's score revealed an average of 71,8 (63.9-79.8) points in group 1 and 67.6 (47.3-78.7) in group 2. When the results of Neer's scores were expressed in percentage of the unaffected arm a mean of 73.6 (65.6-81.8) in group 1 and 69.3 (51.8-86.9) was obtained. The only statistically significant difference was observed within the sub-group of three-part fractures: treated by angle stabile plates (group 1) these patients (n = 8) achieved a mean Neer-Score of 81 (77-86) compared to 68 (52-84) (n = 8). In group 1 70.8 % of patients followed-up presented an "excellent" or "good" result according to Neer's criteria, in group 2 60 % did so. CONCLUSION: We conclude from our first experience with angle stabile plates for fractures of the proximal humerus that particularly in three part fractures this method might improve functional outcome and is worth further consideration and testing.