【摘要】 目的:探讨切开复位、锁定钢板内固定治疗肱骨近端移位骨折的临床疗效,评价并发症发病率和患肩功能的恢复程度,并对PHILOS或LPHP板进行比较。方法:选取2008年1月-2010年6月间因肱骨近端骨折而手术治疗的根据Neer分型划分为2、3或4级的111例患者,通过电话及门诊复查随访1年并进行牛津肩关节评分(OSS)、疼痛程度VAS评分评估及记录相关的并发症及相关处理。结果:92例患者完成术后0.5～1年的随访(83%,92/111),平均年龄为68岁(20～97岁),其中男女比例1:5(18:74),平均的牛津大学肩评分为16.37分(范围:11～54分),0～10的VAS评分测定的疼痛程度平均得分为3.1分。并发症发生率为41.3%(38/92):出血(1.1%)、肱骨头/大结节对合不良(3.3%);慢性疼痛(6.5%),肱骨头缺血性坏死(AVN)(0%);复位丢失和螺钉切出(4.3%);钢板断裂(3.3%);肩峰下撞击(11.9%);肩周炎(4.3%);肩袖撕裂(1.1%);感染(1.1%)。24例患者因上述并发症而行2次手术。结论:锁定钢板治疗肱骨近端移位骨折的临床疗效可靠,虽然其并发症和再手术率较高,但二者的发生率仍稍低于现有的文献报道。更多还原

【Abstract】 Objective:To explore the clinical efficacy of open reduction and locking proximal humerus plate(LPHP) in treating proximal humerus fracture.Methods:From January 2008 to June 2010,111 patients with proximal humerus fracture of Neer type Ⅱ,Ⅲ and Ⅳ,who were treated with open reduction and LPHP,were followed up for the record of OSS,VAS scales as well as the complications.Results:A total of 92 cases finished a half-year to one-year follow-up,with an average of 68 years(20 to 97 years),18 males and 74 females.The mean Oxford Shoulder Score(OSS) was 16.37 and Visual Analogue Scale(VAS) was 3.1.The complication rate was 41.3%: 1.1% hemorrhage rate,3.3% poor connection of humerus head and greater tubercle,6.5% chronic pain,0% avascular necrosis of humerus head,4.3% loss of reduction and cutting-out of the screw,3.3% plate fracture,11.9% collision injury of subacromion,4.3% periarthritis of shoulder,1.1% rotator cuff tears,and 1.1% infection.Twenty-four patients underwent secondary surgery due to the above complications.Conclusion:LPHP is an effective therapy for proximal humerus fracture.Although it has high complications and rate of reoperation,the incidences are lower than those reported in current literature.更多还原