应用肱骨近端锁定钢板治疗肱骨近端骨折

目的观察、评价肱骨近端锁定钢板（LPHP）治疗肱骨近端骨折的疗效。方法通过分析自2008—01—2012—10收治并随访的52例肱骨近端二部分以上骨折。采用有限切开、透视复位、肱骨近端锁定钢板内固定的方法治疗，骨缺损患者采用自体髂骨及人工骨植骨。结果本组获得随访8—25个月（平均15个月），肱骨近端骨折均得到了愈合，按Neer肩关节功能评分标准：优25例，良18例，可6例，差3例，优良率82．7％。未发生断板、断钉，无肱骨头缺血坏死及肩峰撞击综合征。结论应用肱骨近端锁定钢板治疗肱骨近端骨折，骨缺损者取髂骨、人工骨植骨，根据骨折类型及稳定性等指导功能锻炼，骨折愈合良好、并发症少、关节功能恢复好。

Application of locking proximal humerus plate in treatment of proximal humerus fractures

Objective To observe, evaluate the clinical resuh of proximal humerus locking plate （locking proximal humeral plate, LPHP） for the treatment of proximal humeral fractures. Methods Fifty two cases of proximal humeral fractures of Neer two or more parts from January 2008 to October 2012 were analyzed. The limited incision, perspective reduction, proximal humeral locking plate fixation methods were used. The bone defects were treated with autologous iliac and artificial bone graft. Results The patients were followed up for 8 to 25 months （mean 15 months）. The fractures were well healed. According to Neer shoulder function score, the outcome was excellent in 25 cases, good in 18 cases, fair in 6 cases,poor in 3 cases, with excellent and good rate of 82.7%. There were no occurrence of broken plates, broken nails, no humeral head necrosis, no occurrence of impingement syndrome. Conclusion It is an effective treatment method to use locking proximal humeral plate for proximal humeral fractures, autologous iliac and artificial bone graft for bone defects, and to provide functional exercise guidance according to the type of fracture and the stability. The fracture heals well, there are fewer complications, joint function recovers well.