【摘要】 [目的]探讨应用锁定加压接骨板(locking compression plate,LCP)治疗肱骨近端复杂骨折的疗效。[方法]2005年4月~2006年6月,应用锁定加压接骨板治疗肱骨近端骨折21例,男13例,女8例;年龄26~71岁,平均42.3岁。根据Neer分型,3部分骨折15例,其中5例伴前脱位,6例伴有原发性骨质疏松;4部分骨折6例,其中3例伴肱骨头前脱位,2例伴后脱位。手术采用三角肌、胸大肌间隙入路,将锁定钢板置于结节间沟后缘10mm,近端距肱骨大结节顶点下5mm的位置,复位后骨折断端如有骨质缺损,进行自体或异体骨植入,骨折远近端分别用锁定及非锁定螺钉固定。术后第3d肩关节适量被动活动,1周后开始主动活动,2周后加强功能锻炼。[结果]本组21例手术患者均获得10~14个月的随访,平均12.5个月,骨折12个月内全部愈合。按Neer肩关节功能评分标准评定:优11例,良7例,可3例,全组优良率85%。[结论]锁定钢板的螺钉锁扣于接骨板上,能够提高对肱骨近端粉碎骨折及伴有骨质疏松患者的固定效果,做到骨折愈合与功能锻炼同步,但应注意对锁定接骨板的合理操作,尽量避免锁定引起的一系列问题。更多还原

【Abstract】 [Objective]To discuss the treatment effect of locking compression plate(LCP)for proximal humeral complicated fractures.[Method]A retrospective study was done on 21 cases of proximal humeral fractures treated with LCP from April 2005 to June 2006.There were 13 male and 8 female,with age of 26-71 year(mean 42.3 year).According to Neer classification,15 cases were three-part fractures including 5 cases with anterior dislocation and 6 cases with primary osteoporosis;6 cases were four-part fractures including 3 cases with anterior dislocation and 2 cases with posterior dislocation.Reduction and fixation were done by deltopectoral-gap approach,the operator put the locking plate on 10mm positerior to the intergroove of tuberosity,5mm away from the tip of humeral greater tuberosity.If there were bone defects in the fracture site after reduction,they were treated with allografts,locking screws and unlocking screws were drilled into proximal and distal part of the fracture.Shoulder exercise should be performed passively three days after operation.One week after operation,active shoulder exercise was done,which was gradually intensified two weeks after operation.[Result]Twenty-one cases were followed up for 10-14 months,average 12.5 months,all fractures were union in 12 month.According to Neer shoulder score,the result was excellent in 11 cases,good in 7 and fair in 3,with excellent and good rate of 85%.[Conclusion]The screw of LCP can lock the plate so that the plate can firmly fixate the proximal humeral comminution fractures and osteoporosis bone,so simultaneously reach fracture union and function exercise,but attentions should be paid to the suitable procedure of LCP to avoid a series of problem of locking plate.更多还原