CAJ | 학술논문

目的探讨肱骨近端锁定型钉(PHILOS)板治疗老年人移位的肱骨近端骨折的疗效。方法回顾性分析2004年2月至2007年3月用PHILOS板治疗的36例肱骨近端骨折患者,Neer分型二部分骨折14例，三部分骨折17例，四部分骨折5例。统计手术时间、输血量和手术并发症，评价肩关节功能。结果患者平均年龄72.2岁，平均随访14.5个月。术中平均输血165.2 ml，术后X线显示骨折复位满意，无神经、血管损伤病例，心脑血管意外1例，肺炎1例，骨折愈合时间3～5个月，未发现肱骨头坏死,Neer评分：30例(83.3％)优良。分析显示骨折类型（Neer分型）、受伤至手术时间（术后3d内早期手术）与骨折愈合后肩关节功能恢复具有相关性，年龄、性别、美国麻醉医师协会(ASA)评分与Neer评分两组比较差异无统计学意义。结论 PHILOS板是治疗老年人移位的肱骨近端骨折的有效方法，固定牢固稳定，可早期功能锻炼，适合于伴有骨质疏松的老年患者。
목적 탐토굉골근단쇄정형정(PHILOS)판치료노년인이위적굉골근단골절적료효。방법 회고성분석2004년2월지2007년3월용PHILOS판치료적36례굉골근단골절환자,Neer분형이부분골절14례，삼부분골절17례，사부분골절5례。통계수술시간、수혈량화수술병발증，평개견관절공능。 결과 환자평균년령72.2세，평균수방14.5개월。술중평균수혈165.2 ml，술후X선현시골절복위만의，무신경、혈관손상병례，심뇌혈관의외1례，폐염1례，골절유합시간3～5개월，미발현굉골두배사,Neer평분：30례(83.3％)우량。분석현시골절류형（Neer분형）、수상지수술시간（술후3d내조기수술）여골절유합후견관절공능회복구유상관성，년령、성별、미국마취의사협회(ASA)평분여Neer평분량조비교차이무통계학의의。 결론 PHILOS판시치료노년인이위적굉골근단골절적유효방법，고정뢰고은정，가조기공능단련，괄합우반유골질소송적노년환자。
Objective To investigate the treatment effect of the proximal humeral internal locking system (PHIL()S) on the elderly patients with displaced proximal humeral fractures.Methods From Feb 2004 to Mar 2007, 36 patients (mean age: 72.2 years) with proximal humeral fractures were treated with PHILOS plate fixation which included 14 cases with 2-part, 17 cases with three-part and 5 cases with four-part fractures according to Neer classification. Operation time,intraoperative blood loss, blood transfusion, perioperative complications and function evaluation of the operated shoulder joint were calculated with 14.5 months follow-up at average.Results The average operation time and blood loss were (61.5± 11.6) min and ( 165.2±91.2) ml, respectively. 1 case with accidents of blood vessel and 1 case with pneumonia were found without neurovascular injuries. All fractures were radiographically healed in an average of 3-5 months. No necrosis of humeral head appeared and 30 (83.3％) cases were excellent or good according to Neer scoring system. Two part fracture and early operation ( within 3 days after operation) might improve the postoperative function of shoulder joint, but the patient's age, gender and ASA score were not statistically with Neer score.Conclusions PHILOS plate fixation is a suitable procedure for displaced proximal humeral fractures via stable fixation and early rehabilitation, especially for elderly patients combined with osteoporosis.