PHILOS钢板微创治疗老年肱骨近端骨折的疗效观察

目的探讨老年肱骨近端骨折的微创手术治疗。方法采用肩部外侧小切口手术入路，使用PHILOS锁定钢板治疗老年肱骨近端骨折42例，评价疗效。结果3例患者失访，余患者均得到随访，随访时间为4～13m，无伤口感染，无上举乏力，无复位丢失，无内固定松动，无骨折不愈合，无肱骨头坏死，愈合时间为12～20W。肩关节功能采用Neer评分法，优23例，良12例，可4例。优良率为89．7％。结论肩部外侧小切口手术入路结合PHILOS锁定钢板治疗老年肱骨近端骨折具有手术时间短，损伤小，术中出血少及术后功能恢复好。

Clinical observation of PHILOS plate fixation in minimally invasive treatment of proximal humerus fracture in the elderly patients

Objective To explore the clinical results of the treatments of the elderly proximal humeral fractures with minimally invasive surgery. Methods Through shoulder lateral small incision surgical approach, 42 elderly cases with proximal humeral fractures were treated by using PHILOS locking plate. The curative effect was evaluated. Results Three patients were lost to follow-up, the other patients were followed up for 4 - 15 months. No complication such as wound infection, should lack of power, reset lost, internal fixation loosening, nonunion, head of the humerus necrosis were found. All fractures were united clinically and radiologically at a mean of 12 to 20 weeks. By neer score, 23 cases were graded as excellent, 12 as good and 4 as passable. The excellent and good rate was 85.7%. Conclusion Shoulder lateral small incision surgical approach with PHILOS plate treating elderly proximal humerus fracture has less operation time, less injury, less intraoperative bleeding and postoperative function may recover well.