PHILOS接骨板治疗复杂肱骨近端骨折

【摘要】 目的评价肱骨近端内固定锁室系统(PHILOS)接骨板治疗复杂骨折的临床疗效。方法2006年1月至2008年3月,应用PHILOS接骨板治疗复杂肱骨近端骨折26例,男16例,女10例;年龄35~72岁,平均55.5岁,左侧19例,右侧7例;按Neer分型三部分骨折18例,四部分骨折8例,采用Constant-murley肩关节评分标准。对患者健侧患侧肩关节进行评分,同是计算患侧评分占健侧评分的百分比,>80%为优良,60%~80%为满意,<60%为差。结果26例患者均获得随访,随访时间5~24个月,平均11.2个月。骨折愈合时间9~21周,平均13周。骨折端无移位,螺钉无松动、拔出及断钉,患侧肱骨头较健侧无吸收、缩小征象。患侧肩关节前屈上举活动度为120°~170°,平均150°。末次随访时Constant-murley评分平均80.5分(62~92分);患侧评分占健侧评分的百分比为75.5%~96.5%,平均85.5%;优良12例,满意11例,差3例,优良率88.4%。结论应用PHILOS锁定加压接骨板治疗复杂肱骨近端骨折可获得较理想的临床疗效。更多还原

【Abstract】 Objective To evaluate the clinical outcomes of the proximal humeral internal locking system (PHILOS) plate treating the complex proximal humeral shaft fractures.Methods From January 2006 to March 2008,a total of 26 patients with acutely complex proximal humeral shaft fractures were treated by open reduction and internal fixation using the PHILOS plate.There were 16 males and 10 femals with an average age of 55.5 years (range,35- 72),the left side was involved in 19 cases,and the right side was involved in 7 cases.According to Neer classification,18 cases belonged to 3 parts , 8 to 4 parts,and assessment was done using the Constant- murley shoulder score and percentage Constant- murley score,>80% was excellent or good,60%- 80% was satisfactory,and <60% was poor.Results In all patients,the mean follow- up time was 11.2 month(range,5- 24 months)The mean fractures healing time was 13 weeks (range,9- 21 weeks).No complications were found,such as delayed union and nonunion, displaced,avascular necrosis,cutout or backout of the scews and plates.The mean ROM of the shoulders was 150° (range, 120° ~170° ).The Constant- Murley score of the injury side was mean 80.5 (range,62- 92) at the final follow- up,which was 85.5% (range,75.5% - 96.5% )of the Constant- Murley score of normal side.The clinical outcomess were excellent or good in 12 cases (85.5%),satisfactory in 11 cases.Conclusion According to our experience,the PHILOS plate design provides stable fixation with a good functional outcome for the complex proximal humeral shaft fractures and eliminates most hardware problems and complications.更多还原