CAJ | 학술논문

目的：探讨应用加长型Philos系统治疗肱骨近端骨折的的手术方法及疗效。方法回顾性分析2009年1月至2012年12月期间我科同一组医生采用加长型Philos系统治疗肱骨近端骨折17例患者，其中女12例，男5例，平均年龄71岁（62~85岁）。伤后2~5 d实施手术，患者取“沙滩椅位”或仰卧位，选择延长的肱骨近端切口，术中直视下复位骨折，采用加长型Philos钛板螺钉固定。术后即刻，以及术后1、3、6、12个月复查X线片观察骨折愈合情况。结果所有患者术后X线片显示肱骨近端骨折复位满意，钛板螺钉位置良好。随访6~32个月（平均16.8个月），骨折均愈合，无肱骨头坏死、内固定松动断裂及伤口感染等并发症发生。按Neer肩关节功能评分标准进行疗效评价，优10例，良4例，可3例，优良率为82.4％。结论加长型Philos系统具有设计合理、安装相对容易、固定牢靠的优点，是治疗肱骨近端骨折的有效选择之一。
목적：탐토응용가장형Philos계통치료굉골근단골절적적수술방법급료효。방법회고성분석2009년1월지2012년12월기간아과동일조의생채용가장형Philos계통치료굉골근단골절17례환자，기중녀12례，남5례，평균년령71세（62~85세）。상후2~5 d실시수술，환자취“사탄의위”혹앙와위，선택연장적굉골근단절구，술중직시하복위골절，채용가장형Philos태판라정고정。술후즉각，이급술후1、3、6、12개월복사X선편관찰골절유합정황。결과소유환자술후X선편현시굉골근단골절복위만의，태판라정위치량호。수방6~32개월（평균16.8개월），골절균유합，무굉골두배사、내고정송동단렬급상구감염등병발증발생。안Neer견관절공능평분표준진행료효평개，우10례，량4례，가3례，우량솔위82.4％。결론가장형Philos계통구유설계합리、안장상대용역、고정뢰고적우점，시치료굉골근단골절적유효선택지일。
Objective To evaluate the clinical effect of the Surgical Treatment of the Proximal Humeral Fractures Using the Long Philos System. Methods A total 17 cases with the proximal humeral fractures from Jun 2009 to Nov 2012 underwent surgical treatment with the long Philos system. The operation were done by one group of experienced trauma surgeon at 2 to 5 days after injury. The patient was positioned in the beach-chair position or supine. The humeral anterolateral approach was used. The skin incision was approximately 15 to 20 cm long,beginning at the coracoid and angled distally to the deltoid tuberosity. then extended along the lateral of the bicep. In the operation,the fracture was reduced and fixed by the long Philos system. The bone union were evaluated for all patients after operation. Results The postoperative radiographs verified good position of plate and screws,with satisfactory fracture reduction and no neurovascular injury(such as axillery nerve and humeral artery)happened. The periods of follow-up were 6 ~32 months of all the patients. No necrosis of humeral head,no delayed union and ununion happened. All the fractures healed in 8 to16 weeks. According to Neer scoring system,the excellent and good rate was 82. 4%. ConclusionThe Long Philos System has anatomical and reasonable design and can be used to treat the fractures of proximal humerus.