锁定肱骨近端接骨板治疗肱骨近端复杂骨折

目的研究采用有限切开复位技术和锁定肱骨近端接骨板（LPHP）内固定治疗复杂性肱骨近端骨折的临床治疗效果。方法 2004年1月至2007年6月收治20例3、4部分肱骨近端骨折患者,所有骨折均采用切开囊内复位技术进行治疗,采用Neer骨折分类及评分标准进行手术疗效的评价。结果 20例均得到随访,随访时间3~23个月,平均时间13个月,骨折都顺利愈合,愈合时间3~5个月,按Neer肩关节功能评分,优10例,良8例,优良率90.0%,未发现肱骨头缺血性坏死病例。结论采用切开囊内复位技术和LPHP锁定肱骨近端接骨板内固定治疗肱骨近端骨折可减轻对肱骨头血运的影响,提高骨折复位的有效性和固定的稳定性。

Clinical application of LPHP in treatment of proximal humeral frachure.

Objective To study the treating result of complexproximal humeral fractures using the techniques of open intracapsular reduction and intermal fixation with locking proximal humeral plate（LPHP）.Methods A group of 20 cases of three and four part proximal humeral fractures（from January 2004～June 2007） were treated with the techniques of open intracapsular reduction.Neer fracture classification and rating system were used.Results The follow-up period was 3～23months（mean 13months）.All cases were healed and the union period of 3～5months.According to the Neer shoulder score,the results showed that ten cases were excellent,8 cases good,with excellent rate of 90.0%,Avascular necrosis of humeral head did not occur in all fractures.Conclusion The operative techniques of open in tracapsular reduction and internal fixation with locking proximal humeral plate can enhance validity of reduction and stability of fixation,and alleviate the disturbance on vascular supply of the humeral head.