锁定加压钢板联合内侧支撑钢板治疗骨质疏松性肱骨近端粉碎性骨折
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作者Author单位AddressE-Mail
梅正峰 MEI Zheng-feng 浙江中医药大学附属杭州第三医院, 浙江 杭州 310000 Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China meizhengfeng@126.com 
雷文涛 LEI Wen-tao 浙江中医药大学附属杭州第三医院, 浙江 杭州 310000 Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China  
黄东辉 HUANG Dong-hui 浙江中医药大学附属杭州第三医院, 浙江 杭州 310000 Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China  
马伟 MA Wei 浙江中医药大学附属杭州第三医院, 浙江 杭州 310000 Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China  
潘国标 PAN Guo-biao 浙江中医药大学附属杭州第三医院, 浙江 杭州 310000 Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China  
倪凌之 NI Ling-zhi 浙江中医药大学附属杭州第三医院, 浙江 杭州 310000 Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China  
韩志伟 and HAN Zhi-wei 浙江中医药大学附属杭州第三医院, 浙江 杭州 310000 Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China  
期刊信息:《中国骨伤》2022年,第35卷,第12期,第1193-1196页
DOI:10.12200/j.issn.1003-0034.2022.12.016
基金项目:
中文摘要:

目的:探讨肱骨近端外侧锁定加压钢板联合内侧支撑钢板治疗骨质疏松性肱骨近端粉碎性骨折的临床疗效。

方法:自2017年5月至2021年12月采用肱骨近端外侧锁定加压钢板联合内侧支撑钢板治疗12例骨质疏松性肱骨近端粉碎性骨折患者,男5例,女7例;年龄55~78岁;骨密度<-2.5 g/cm3;伤后至手术时间2~6 d。Neer分型:Ⅲ型骨折7例;Ⅳ型骨折4例;Ⅵ型1例。观察患者手术并发症及内固定情况,并于术后6个月采用Constant-Murley评分评价肩关节功能。

结果:术后伤口Ⅰ期愈合。12例患者均获得随访,时间6~18个月。肱骨头塌陷坏死1例,肱骨头内翻1例,无肩关节撞击、内固定松动等并发症发生。术后6个月Constant-Murley肩关节评分45~90分,其中优6例,良3例,差3例。

结论:锁定加压钢板联合内侧支撑钢板固定可有效重建肱骨内侧柱支撑,加强骨折稳定性,术后疗效满意。但因未设立对照组,术后肩关节功能未多次评价,不能动态反应肩关节功能变化。
【关键词】肱骨  骨折,粉碎性  骨质疏松  骨折固定术
 
Locking compression plate combined with medial buttress plate for the treatment of osteoporotic comminuted proximal humerus fractures
ABSTRACT  

Objective: To explore clinical effect of lateral locking compression plate combined with medial buttress plate in treating osteoporotic comminuted fractures of proximal humerus.

Methods: From May 2017 to December 2021, 12 patients with osteoporotic comminution of proximal humerus were treated by lateral locking compression plates combined with medial buttress plates, including 5 males and 7 females, aged from 55 to 78 years old, bone mineral density(BMD) less than -2.5 g/cm3, the time from injury to operation was from 2 to 6 days. According to Neer classification, 7 patients were type Ⅲ, 4 patients were type Ⅳ and 1 patient was type Ⅵ. Postoperative complications, fracture healing and internal fixation were observed and Constant-Murley score of shoulder joint was used to evaluate clinical effects at 6 months after operation.

Results: Postoperative wound healed well at stage I. All patients were followed up from 6 to 18 months. Humeral head collapse and necrosis occurred in 1 patient and humeral head varus in 1 patient. No impact of shoulder joint, internal fixation loosening occurred. Constant-Murley score at 6 months ranged from 45 to 90 points, and 6 patients got excellent result, 3 good, and 3 poor.

Conclusion: Locking compression plate combined with medial buttress plate could effectively reconstruct medial humeral column support and enhance fracture stability, and receive satisfactory clinical results. However, no control group was established in this study, and function of shoulder joint has not been evaluated many times after operation, so it cannot dynamically reflect changes of shoulder joint function.
KEY WORDS  Humerus  Fratcures,comminuted  Osteoporosis  Fracture fixation
 
引用本文,请按以下格式著录参考文献:
中文格式:梅正峰,雷文涛,黄东辉,马伟,潘国标,倪凌之,韩志伟.锁定加压钢板联合内侧支撑钢板治疗骨质疏松性肱骨近端粉碎性骨折[J].中国骨伤,2022,35(12):1193~1196
英文格式:MEI Zheng-feng,LEI Wen-tao,HUANG Dong-hui,MA Wei,PAN Guo-biao,NI Ling-zhi,and HAN Zhi-wei.Locking compression plate combined with medial buttress plate for the treatment of osteoporotic comminuted proximal humerus fractures[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(12):1193~1196
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