【摘要】 介绍徐志强教授治疗肱骨近端骨折的临床经验。徐志强教授认为，对适合非手术治疗的肱骨近端骨折患者运用手法整复与小夹板外固定治疗，经过早期功能锻炼与内外治法相结合治疗，可获得良好的功能恢复效果。临证宜首先判断骨折的解剖结构及其移位程度并分型，对于适合非手术治疗者，采用正骨十四法整复骨折并小夹板外固定。强调手法复位前需明白手法整复的目的，凡行手法整复均需先通过“触摸辨认”法辨明局部骨折端的移位、成角，在手法复位前适当辅以理筋手法。注重骨折康复治疗，遵从中医骨伤科原则“动静结合、筋骨并重、内外兼治、医患合作”。手法整复及小夹板固定后，中药调理以行气活血为主，辅以健脾养精，重视从气血三期辨证论治，同时结合陈渭良教授的伏瘀理论，随证施治。更多还原

【Abstract】 This paper is to introduce Professor XU Zhiqiang’s clinical experience in treating proximal humerus fracture.He believes that for patients with proximal humerus fractures and suitable for non-surgical treatment should be given manual reduction and external fixation of small splints, which can achieve good functional recovery after early functional exercise combined with internal and external treatment.In clinical practice,it should firstly evaluate the anatomical structure of the fracture and its degree of displacement and classification.For those suitable for non-surgical treatment,the fracture should be reduced by fourteen bone-setting manipulation and external fixation of small splints.It is emphasized that the manual reduction should be taken after understanding its purpose.All manual reduction should first identify the displacement and angulation of local fracture end by “identification by touch” method,and should be supplemented by therapeutic manipulation for tendon injury before.With focus on rehabilitation treatment of fracture,it should follow the principles of Chinese medicine orthopedics “combination of static and dynamic treatment,emphasizing both tendons and bones,internal and external treatment,and doctor-patient cooperation”.After manual reduction and small splint fixation, the Chinese herbal medicine treatment is mainly to promote qi movement and activate blood, supplemented by boosting the spleen and nourishing essence, and attaches importance to syndrome differentiation and treatment from three stages of qi and blood.At the same time,it is treated according to syndrome combined with Professor CHEN Weiliang’s theory of latent blood stasis.更多还原