CAJ | 학술논문

背景:锁定接骨板是一种新型的内固定钢板,可以改善肱骨近端骨折的临床治疗效果.目的:探讨锁定接骨板置入内固定治疗肱骨近端三、四部分骨折疗效以及并发症的发生情况.方法:回顾性分析复旦大学附属中山医院青浦分院骨科2008年1月至2009年12月行锁定接骨板内固定治疗31例肱骨近端骨折患者临床资料,其中男13例,女18例;年龄28-81岁,平均56.4岁.骨折类型采用 Neer 分类,三部分骨折19例,四部分骨折12例.内固定治疗采用胸大肌三角肌间沟入路,行肱骨近端锁定接骨板内固定术.另外,检索锁定接骨板治疗肱骨近端三、四部分骨折并发症的相关研究文献,对并发症的发生情况进行研究分析.综合分析临床病例疗效与检索文献中并发症的发生情况,获得锁定接骨板治疗肱骨近端三、四部分骨折的特点.结果与结论:复旦大学附属中山医院青浦分院骨科应用锁定接骨板内固定治疗31例患者均得到13-49个月随访,平均随访19.8个月.骨折均愈合,无内固定失效,临床愈合时间为8-16周.根据 Constant评分标准评定肩关节功能,其中优11例,良16例,可3例,差1例.锁定接骨板内固定是治疗肱骨近端三、四部分骨折可靠有效的方法.但也可发生螺钉松动、肱骨头坏死等相关并发症,因此,内固定治疗操作时应注意保护肱骨头血运,复位肱骨颈内侧骨折块并牢固固定,以减少并发症的发生,提高内固定治疗疗效.
배경:쇄정접골판시일충신형적내고정강판,가이개선굉골근단골절적림상치료효과.목적:탐토쇄정접골판치입내고정치료굉골근단삼、사부분골절료효이급병발증적발생정황.방법:회고성분석복단대학부속중산의원청포분원골과2008년1월지2009년12월행쇄정접골판내고정치료31례굉골근단골절환자림상자료,기중남13례,녀18례;년령28-81세,평균56.4세.골절류형채용 Neer 분류,삼부분골절19례,사부분골절12례.내고정치료채용흉대기삼각기간구입로,행굉골근단쇄정접골판내고정술.령외,검색쇄정접골판치료굉골근단삼、사부분골절병발증적상관연구문헌,대병발증적발생정황진행연구분석.종합분석림상병례료효여검색문헌중병발증적발생정황,획득쇄정접골판치료굉골근단삼、사부분골절적특점.결과여결론:복단대학부속중산의원청포분원골과응용쇄정접골판내고정치료31례환자균득도13-49개월수방,평균수방19.8개월.골절균유합,무내고정실효,림상유합시간위8-16주.근거 Constant평분표준평정견관절공능,기중우11례,량16례,가3례,차1례.쇄정접골판내고정시치료굉골근단삼、사부분골절가고유효적방법.단야가발생라정송동、굉골두배사등상관병발증,인차,내고정치료조작시응주의보호굉골두혈운,복위굉골경내측골절괴병뢰고고정,이감소병발증적발생,제고내고정치료료효.
@@@@BACKGROUND: The locking plate is a new type of internal fixation plates which can improve the clinical treatment effect of proximal humeral fractures. OBJECTIVE: To explore the effect of locking plate fixation for the treatment of 3-part and 4-part fracture of proximal humerus, and to explore the incidence of complications. METHODS: Thirty-one proximal humeral fracture patients (13 males and 18 females, aged from 28 years to 81 years, averaged in 56.4 years) treated with locking plate fixation were selected from Department of Orthopedics, Qingpu Branch of Zhongshan Hospital, Fudan University between January 2008 and December 2009. The clinical data of the 31 patients was retrospectively analyzed. The type of fracture was classified with Neer classification, and found that 19 patients had 3-part fracture and 12 patients had 4-part fracture. The internal fixation was performed with pectoralis major deltoid interscalene approach and then the proximal humeral locking plate fixation was performed. The literatures on the locking plate for the treatment of 3-part and 4-part fracture of proximal humerus were searched to analyze the incidence of complications. The efficacy of clinical cases and in the incidence of complications the retrieved documents were comprehensively analyzed, and the features of locking plate for the treatment of 3-part and 4-part fracture of proximal humerus were obtained. RESULTS AND CONCLUSION: Al the 31 patients mentioned above were fol owed-up for 13-49 months, average in 19.8 months. The fracture of al the patients were healed without fixation failure and the clinical healing time was 8-16 months. The shoulder function was assessed according to the Constant assessment criteria, and found that excel ent in 11 patients, good in 16 patients, average in 3 patients and poor in 1 patient. Locking plate fixation is the reliable and effective method for the treatment of 3-part and 4-part fracture of proximal humerus. But the screw loosening, humeral head necrosis and other related complications may also occur. Therefore, we should pay attention to protect the blood supply of the humeral head during fixation and reset the medial humeral neck fracture and firmly fixed, in order to reduce the complications and improve the treatment effect of fixation.