CAJ | 학술논문

目的：探讨微创结合加长型肱骨近端锁定钢板（ PHILOS钢板）治疗肱骨近端伴肱骨干骨折的临床疗效。方法：从2010年5月至2013年12月，采用微创技术结合加长型PHILOS钢板治疗肱骨近端伴肱骨干骨折17例。结果：17例患者均随访6～20个月，平均14个月。所有病例均达到骨性愈合，无内固定断裂及退钉等并发症出现。1例患者术后出现桡神经损伤症状，经对症治疗后于16周恢复。2例出现肩关节轻度疼痛，经理疗及口服止痛药物后逐渐缓解。采用Neer标准评定肩关节功能，优10例，良5例，优良率88．2％；采用HSS标准评定肘关节功能，优15例，良2例，优良率100％，结论：采用微创技术结合加长型PHILOS是治疗肱骨近端伴肱骨干骨折的一种良好方法，其血供破坏少、固定可靠，功能恢复快，满意度高。
목적：탐토미창결합가장형굉골근단쇄정강판（ PHILOS강판）치료굉골근단반굉골간골절적림상료효。방법：종2010년5월지2013년12월，채용미창기술결합가장형PHILOS강판치료굉골근단반굉골간골절17례。결과：17례환자균수방6～20개월，평균14개월。소유병례균체도골성유합，무내고정단렬급퇴정등병발증출현。1례환자술후출현뇨신경손상증상，경대증치료후우16주회복。2례출현견관절경도동통，경리료급구복지통약물후축점완해。채용Neer표준평정견관절공능，우10례，량5례，우량솔88．2％；채용HSS표준평정주관절공능，우15례，량2례，우량솔100％，결론：채용미창기술결합가장형PHILOS시치료굉골근단반굉골간골절적일충량호방법，기혈공파배소、고정가고，공능회복쾌，만의도고。
Objective:To investigate the clinical curative effect of the long proximal humerus internal locking system (long-PHILOS) plate combined with minimally invasive treatment for proximal humerus with humeral shaft fracture .Methods:17 cases with proximal humerus with hu-meral shaft fracture were treated with long-PHLOS plate combined with minimally invasive surgery from May 2010 to December 2013.Results:All cases were followed up for the average of 14 months (from 6 to 20).All cases obtained bone union, with no occurrence of complications such as breaking and loosening of internal fixation.Postoperative symptoms of radial nerve injury appeared in 1 case, which were cured about 16 weeks after the effective treatment.Mild pain in shoulder joints presented in 2 cases, but the symptom was gradually relieved with the application of physical therapy and oral analgesics.The function of shoulder joints under Neer criteria was evaluated as excellent in 10 cases and good in 5 cases, with the excellent and good rate 88.2%.By HSS standard, 15 cases of the function of elbow joints were graded as excellent, and 2 cases of that as good, with the excellent and good rate 100%.Conclusion:It is a favorable way to treat proximal humerus with humeral shaft fracture with long -PHLOS plate combined with minimally invasive surgery, which provides a solid fixation, less damage to blood supply and fast function recovery with high degree of satisfaction.