PHILOS锁定钢板治疗肱骨近端骨折的临床疗效观察-第三军医大学学报.docVIP

PHILOS锁定钢板治疗肱骨近端骨折的临床疗效观察 黄伟弘，倪卫东，宋昭君 （400016 重庆，重庆医科大学附属第一医院骨科） [摘要] 目的 探讨采用PHILOS锁定钢板治疗肱骨近端粉碎性骨折的临床疗效。方法 收集2010年1月至2012年6月，应用PHILOS锁定钢板治疗16例肱骨近端骨折患者，通过影像学资料、Constant-Murley评分(Constant-Murley score, CMS)及美国肩肘外科医师(American Shoulder and Elbow Surgeons, ASES)评分对患者骨折愈合情况、肩关节功能及并发症等进行评估。结果 16例患者均获随访，平均随访时间17（6～25）个月。其中16例（100%）患者获得骨性愈合，14例患者基本获得解剖复位（87.5%），1例（6.2%）患者术后肩关节轻度疼痛，1例（6.2%）患者术后肩关节功能严重障碍。所有病例均无钢板螺钉断裂、肱骨头缺血性坏死发生；平均ASES评分为80.5（40～96）分,平均 Constant 评分为72.4 (32～93) 分；其中患肢肩关节功能优12例（75.0%）、良3例 (18.7%)、差1例 (6.2%)。结论 采用PHILOS锁定钢板治疗肱骨近端粉碎型骨折，尤其对老年性骨质疏松患者，不仅可提供稳定的骨折固定，而且能进行早期功能锻炼，从而取得较好的疗效。 [关键词] 肱骨近端粉碎性骨折；PHILOS锁定钢板；内固定；Constant-Murley评分；ASES评分 [中图法分类号] [文献标志码] A The clinical study of PHILOS locking plate for the treatment of the comminuted proximal humeral fracture Huang Weihong，Ni Weidong，Song Zhaojun（Department of orthopaedics, the first affiliated hospital of Chongqing medical university, Chongqing 400016） [Abstract] Objectives The purpose of this study was to evaluate functional outcomes of the comminuted proximal humerus fractures treated with the PHILOS locking plate. Methods The comminuted proximal humerus fractures of 16 patients were treated with the PHILOS locking plate and followed up over a median period of 17 months (range 6 to 25months) by clinically and radiographically. All patients received a similar therapy following open reduction and internal fixation with the PHILOS plate. The final follow-up included anteroposterior and lateral x-rays, the Constant Score and the American Shoulder and Elbow Surgeons (ASES) score. Results At the final follow-up, union was observed in 16 patients (100%), 14 fractures (87.5%) healed in good anatomical position by radiographically. There was no evidence of screw penetration into the joint primarily or secondarily and no evidence of avascular necrosis(AVN) as well as screw cutout at most recent follow-up. However, one patient suffered slight shoulder joint pain. Cli