切开复位锁定接骨板固定治疗老年肱骨近端骨折的近期疗效

目的探讨切开复位锁定接骨板固定治疗老年肱骨近端骨折的近期疗效。方法回顾分析2007年5月～2011年1月间因移位性肱骨近端骨折接受锁定接骨板切开复位内同定治疗的98例（98肩）老年患者资料。术后进行临床及影像学随访，记录患者的骨折愈合时间、并发症情况。采用视觉模拟疼痛评分（VAS）、美国肩肘关节外科医师评分（ASES）对患者临床效果进行评估。结果所有患者均获随访，平均随访时间为16个月。1例因术后发生肱骨头坏死行肩关节置换，其余97例骨折均获得愈合，平均骨折愈合时间为4．5个月。6例出现一定程度肩关节周围肌肉挛缩。所有患者均未发生手术部位感染。平均VAS评分从术前（7．9±1．2）分降低到末次随访时的（1．9±0．8）分（P〈0．05）；平均ASES评分从术前的（13．7±9．6）分提高到末次随访时的（91．8±12．5）分（P〈0．05）。结论切开复位锁定接骨板同定治疗老年肱骨近端骨折的近期疗效满意，肱骨头坏死发生率低。

The early effect of open proximal humerus plate in proximal fractures reduction and internal treatment of the elderly fixation with locking patients with humeral

Objective To observe the early effect of open reduction and internal fixation with locking proximal humerus plate （LPHP） in treatment of proximal humeral fracture of elderly patients. Methods Ninety-eight patients （98 shoulders） with displaced proximal humeral fractures who were treated with open reduction and internal fixation with LPHP were reviewed, and then they were given clinical and radiographic follow-up, the American shoulder and elbow surgeons （ASES） and visual analogue scale （VAS） were recorded. Radiographic evaluation was used to evaluate implant fixation and osteolysis. The fracture healing time and complications were recorded. Results All patients were followed Ul~, the average follow-up time was 16 months. One patient with postoperative humeral head necrosis was given shoul- der replacement. The remaining 97 cases were all healed. The average fracture healing time was 4.5 months. Six cases had muscles contracture around the shoulder. The mean preoperative VAS and ASES score were （7.9±1.2） points and （13.7±9.6） points respectively. At the time of final follow-up, the mean VAS and ASES score were （1.9±0.8） points and （91.8±12.5） points respectively, VAS score was reduced, and ASES score was improved （P 〈 0.05）. No patient had in- fections after surgery. Conclusion The early effect of open reduction and internal fixation with LPHP in treatment of the elderly patients with humeral proximal fractures is satisfactory. It have low rate of complications