锁定钢板治疗移位性肱骨近端骨折疗效分析

目的 分析锁定钢板治疗移位性肱骨近端骨折疗效.方法 回顾分析了2010年1月至2012年1月采用骨折切开复位肱骨近端锁定钢板内固定术治疗肱骨近端骨折患者36例,按Neer分型：二部分骨折10例,三部分骨折18例,四部分骨折8例.应用Constant score标准评价疗效.结果 36例均获随访,随访时间12～36个月,平均19个月.所有患者骨折均获骨性愈合,无螺钉松动、钢板断裂、肱骨头坏死.1例出现肩峰下撞击;1例出现锁钉螺钉穿过关节面.按照Constant score标准：优9例,良21例,中6例,优良率为83.3％.结论 采用锁定钢板内固定治疗肱骨近端移位骨折固定牢靠,可以早期功能锻炼,术后功能恢复满意,值得提倡.

Clinical effect of internal fixation with the locking plate for displaced proximal humeral fractures

Objective To assess the functional outcome following internal fixation with the locking plate for displaced proximal humeral fractures.Methods We reviewed 36 consecutive patients treated surgically with the proximal humeral locking plate for displaced proximal humeral fracture from January 2010 to January 2012.The average age of the patients was 54 years （range,25～70 years）.According to Neer classification,10 cases were 2-part fracture,18 cases were 3-part fracture and 8 cases were 4-part fracture.Functional outcome was evaluated using Constant score calculation.Results All the patients were followed up for 12 to 36 months （19 months in average）.All fractures united without screw loosening,plate breakout and osteonecrosis of the humeral head.One patient was found to have subacromial impingement,another one was found to have screw perforation of the humeral head.According to Constant score,the result was excellent in 9 cases,good in 21 cases and moderate in 6 cases,with the excellent and good rate of 83.3%.Conclusion Internal fixation of displaced proximal humeral fracture with the proximal humeral locking plate has such advantages as stable fixation,earlier rehabilitation,and satisfactory functional recovery,which is worthy of promotion.