【摘要】 目的观察肱骨近端锁定钢板治疗肱骨近端NeerⅢ、Ⅳ型骨折的临床疗效。方法48例肱骨近端骨折，其中男32例，女16例。患者平均年龄53.6岁(22~78岁)。按Neer分型：NeerⅢ型27例，NeerⅣ型21例，全部采用肱骨近端锁定接骨板(LPHP)内固定。结果45例获随访8~36个月，平均15.6个月。按照Neer功能评定标准进行评分，优34例，良19例，可2例，优良率为95.6%。结论肱骨近端锁定钢板是治疗肱骨近端NeerⅢ、Ⅳ型骨折的一种创新优异的方法，值得推广。
【关键词】 肱骨近端骨折 锁定接骨板 内固定 手术
Treatment of Neer III and Ⅳ Proximal Humeral Fracture with Locking Proximal Humeral Plate
Fang Dabiao，Wang Qiugen，Zhang Ping，Lu Yanghu，Fang Wei, Shen Hong
1.Department of orthopaedics,PLA No.532 Hospital, Huangshan 245041, China;
2. Department of Orthopaedics, Changhai Hospital of Second Military Medical University, Shanghai 200433, China
Abstract： ObjectiveTo investigate the clinical result of the treatment of Neer III and Ⅳ proximal humeral fracture with locking proximal humerus plateMethodsFortyeight patients including 32 males and 16 females with proximal humeral fracrure were treated with locking proximal humeral plate. The average age of the patients was 53.6 (22-78) years. According to Neer’s classification, there were 27 cases of type Ⅲ, and 21 cases of type Ⅳ. ResultsOf the whole patients, 45 were followed up for 8-36 months (averaging 15.6 months). Nonunion was not found in all the cases. According to Neer scoring system, the therapeutic outcome was excellent in 34, good in 19 and so-so in 2 cases. The excellent and good rate was 95.6%.ConclusionThe treatment of Neer Ⅲ and Ⅳ proximal humeral fracture with locking proximal humeral plate is a perfectly innovational mothed. It is worth of recommending in practice.
Key words： proximal humeral fracture; locking plate; internal fixation; operation
随着人口的老龄化及车祸伤的逐年增多，肱骨近端骨折的发病率不断升高，目前占全身骨折的4%~5%[1]。肱骨近端骨折分型复杂，预后较差，尤其NeerⅢ、Ⅳ型骨折一直是创伤骨科治疗中的重点。近20年来由于内固定技术的提高和内植物的改进，手术治疗在许多情况下已成为第一选择。虽然目前治疗方法较为多样化，但人们一直在努力寻找更为高效的办法治疗肱骨近端骨折。2003年6月—2006年11月我们使用肱骨近端锁定钢板(locking proximal humerus plate，LPHP)治疗Neer分型中的Ⅲ、Ⅳ型骨折48例， 随访45例，取得了满意的疗效。
1临床资料
11一般资料
4
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