长PHILOS结合MIPPO治疗肱骨近段骨折合并肱骨干骨折*

目的探讨长PHILOS结合MIPPO治疗肱骨近段骨折合并肱骨干骨折的适应证、手术技巧和治疗效果。方法从2010年7月~2012年8月,我院共对29例骨近段骨折合并肱骨干骨折住院患者采取长PHILOS结合MIPPO治疗。其中男性22例,女性7例;年龄27~65岁,平均32.7岁,采用Neer评定标准和影像学X线片评价此手术方法的临床疗效。结果 29例患者得到有效随访,随访5~22m,平均10.6m。骨折愈合时间12~41w,28例骨折愈合良好,1例骨折延迟愈合,本组患者未出现血管、神经损伤及内固定物断裂。根据肱骨Neer评定标准,29例患者：优15例,占51.73%;良9例,占31.03%;满意4例,占13.79%,差1例,占3.45%。结论长PHILOS结合MIPPO治疗骨近段骨折合并肱骨干骨折具有创伤小、出血少、并发症少、治疗效果好,是治疗骨近段骨折合并肱骨干骨折的一种有效手段。

Use long PHILOS combined MIPPO to treat the proximal humerus with shaft fractures

Objective To evaluate the surgical indication,technique and clinical results of using long PHILOS combined MIPPO to treat the proximal humerus with shaft fractures.Method From July 2010 to August 2012,we have treated 29 patients,using long PHILOS combined MIPPO to treat the proximal humerus with shaft fractures,male 22 cases,age from 27 to 65 years,average is 32.7 years.According to the Neer shoulder score and results of X-ray and the postoperative complications evaluate the surgical method of clinical curative effect.Result All patients were followed up for operation,the follow-up time 5 months~22 months,an average of 10.6 months.Fractures have healded from 12~41 weeks,1 cases of fracture delayed union,After10 months healed.All patients do not appear blood vessel,nerve damage and breakage of internal fixation.According to the Neer shoulder score： excellent 15 patiens,51.73%;good 9 patients 31.03%;satisfied 4 patients,13.79%;poor 1 patients,3.45%.Conclusion The surgical technique of using long PHILOS combined MIPPO to treat the proximal humerus with shaft fractures has many advantages,such as small trauma,less bleeding,the less complications and goodclicinal treatment effect.It is a kind of effective way to treat the proximal humerus with shaft fractures