锁定钢板加骨移植治疗老年复杂性肱骨近端骨折临床分析

目的：探讨锁定钢板加骨移植治疗老年复杂性肱骨近端骨折的疗效。方法：2005年8月～2008年7月应用肱骨近端锁定钢板加骨移植治疗27例,男9例,女18例;年龄60～82岁,平均71.2岁。按Neer分类法：三部分骨折20例、四部分骨折7例,行肩关节前方弧形切口,切开复位骨移植后锁定钢板固定。结果：本组27例均获得随访,随访时间8～36个月,平均20.2个月,功能评定采用Neer评分标准：优10例、良11例、可3、差3例,优良率为77.8%。结论：锁定钢板加骨移植治疗老年复杂骨近端骨折固定牢靠、并发症少。可以早期进行肩关节的功能康复锻炼,疗效佳。

The clinical Analysis of Elderly Patients with Complex Proximal Humeral Fractures treated with Locking Plate and Bone Graft

Objective：To investigate the locking plate and bone graft for the treatment of elderly patients with complex proximal humeral fractures. Methods：From August 2005 to July 2008, the proximal humeral locking plate and bone graft was applied for the treatment of 27 cases, 9 males and 18 females. According to Neer classification, 20 cases had three-part fracture, 7cases had four-part fracture. All patients underwent an operation of curved incision in the front line of the shoulder joint, open reduction and filling bone, then lock plate fixation. Results：All patients were followed up for 8 to 36 months, with an average of 20.2 months. Based on functional evaluation using Neer score criteria, the effect in 10 patients was rated as excellent, 11 good, 3 fair, and 3 poor. The excellent and good rate was 77.8%. Conclusion：Using the locking plate and bone graft for elderly patients with unstable proximal humeral fractures has the advantages of solid fixation, less complications, good curative effect and early functional exercises for the shoulder joint.