CAJ | 학술논문

　　背景：对于肱骨近端骨折或者严重并发症的患者，需要通过内固定物置入达到有效的固定，这样不会影响到肩关节的活动功能，而且创伤小。目的：探讨经皮钢板内固定联合解剖锁定钢板置入内固定治疗肱骨近端骨折的生物力学特征。方法：选取广州医科大学附属第三医院骨科2007年3月至2011年12月收治的肱骨近端骨折患者75例，观察锁定钢板治疗后的愈合以及内固定后肩关节评分。分析锁定钢板治疗肱骨近端骨折在生物力学方面的优势。结果与结论：①75例患者治疗后均获得随访，随访时间6-24个月，平均13.3个月。②治疗后X射线片显示所有螺钉位置良好，骨折复位满意，骨折均得到了愈合，未发生神经血管损伤以及肱骨头坏死的病例，其中1例出现感染经治疗痊愈，72例无肩痛，3例偶有肩痛。③Neer评分优57例，良11例，中7例，差0例，优良率为90.7%。与其它内固定物比较，锁定钢板治疗肱骨近端骨折的固定强度大，疗效满意，已成为临床治疗肱骨近端骨折的首选。
　　배경：대우굉골근단골절혹자엄중병발증적환자，수요통과내고정물치입체도유효적고정，저양불회영향도견관절적활동공능，이차창상소。목적：탐토경피강판내고정연합해부쇄정강판치입내고정치료굉골근단골절적생물역학특정。방법：선취엄주의과대학부속제삼의원골과2007년3월지2011년12월수치적굉골근단골절환자75례，관찰쇄정강판치료후적유합이급내고정후견관절평분。분석쇄정강판치료굉골근단골절재생물역학방면적우세。결과여결론：①75례환자치료후균획득수방，수방시간6-24개월，평균13.3개월。②치료후X사선편현시소유라정위치량호，골절복위만의，골절균득도료유합，미발생신경혈관손상이급굉골두배사적병례，기중1례출현감염경치료전유，72례무견통，3례우유견통。③Neer평분우57례，량11례，중7례，차0례，우량솔위90.7%。여기타내고정물비교，쇄정강판치료굉골근단골절적고정강도대，료효만의，이성위림상치료굉골근단골절적수선。
BACKGROUND:For the patients with proximal humeral fractures or serious complications, internal fixation is the effective method that cannot influence the activity of the shoulder with few trauma. OBJECTIVE:To investigate the biomechanical characteristics of percutaneous plate combined with anatomical locking plate fixation for the treatment of proximal humeral fractures. METHODS:Seventy-five patients with proximal humeral fractures were selected from Department of Orthopedics, the Third Affiliated Hospital of Guangzhou Medical University between March 2007 and December 2011. The healing after the locking plate fixation and the shoulder joint score after internal fixation were observed. The biomechanical advantages of locking plate fixation in the treatment of proximal humeral fractures were analyzed. RESUTLS AND CONCLUSION:Al the 75 patients were fol owed up for 6-24 months, average 13.3 months. The X-ray film after treatment showed al the screws were in correct position with satisfactory fracture reduction, and the fractures were healed without neurovascular injury and humeral head necrosis;one case had infection and healed after treatment, 72 cases had no shoulder pain, while three cases had occasional shoulder pain. The Neer score was excel ent in 57 cases, good in 11 cases, moderate in seven cases and poor in none, and the excel ent and good rate was 90.7%. Compared with other fixation implants, the locking plate fixation in the treatment of proximal humeral fractures has the advantages of high fixation strength and satisfactory effect, becoming the first choice for the clinical treatment of proximal humeral fractures.