| 同种异体结构植骨加锁定钢板治疗肱骨头塌陷的Neer 4部分骨折 |
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Received:April 20, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘磊 |
LIU Lie |
安徽医科大学附属宿州医院, 安徽 宿州 234000 |
Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China |
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| 杨峰 |
YANG Feng |
安徽医科大学附属宿州医院, 安徽 宿州 234000 |
Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China |
1115097037@qq.com |
| 纵成成 |
ZONG Cheng-cheng |
安徽医科大学附属宿州医院, 安徽 宿州 234000 |
Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China |
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| 陈静 |
CHEN Jing |
安徽医科大学附属宿州医院, 安徽 宿州 234000 |
Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China |
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| 期刊信息：《中国骨伤》2023年36卷，第2期，第116-119页 |
| DOI：10.12200/j.issn.1003-0034.2023.02.004 |
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目的：探讨同种异体股骨头作为结构植骨结合肱骨近端锁定内固定系统(proximal humeral internal locking system,PHILOS)治疗肱骨头塌陷的肱骨近端Neer 4部分骨折的临床疗效。
方法：自2018年1月至2020年11月采用同种异体结构植骨加肱骨近端锁定钢板治疗18例肱骨头塌陷的肱骨近端骨折患者,其中男4例,女14例;年龄55~78(68.11±7.20)岁;骨折按照Neer分型均为4部分骨折。观察患者的手术时间、术中出血量、术后引流量和骨折愈合时间,颈干角、肱骨头的高度丢失情况,骨折愈合情况、内固定断裂及退出情况,末次随访时采用Neer功能评分进行临床疗效评价。
结果：18例患者获得随访,时间10~12(11.08±0.65)个月。手术时间(66.44±5.06) min,术中出血量(206.67±36.14) ml,术后引流量(76.11±9.63) ml,骨折愈合时间(17.28±3.92)周,末次随访颈干角丢失度数(5.44±0.86)°,肱骨头高度丢失(1.43±0.27) mm。所有患者获得骨性愈合,无内固定断裂、退出、穿出及肱骨头坏死等并发症。末次随访时Neer评分(89.61±5.60)分,优10例,良6例,可2例。
结论：同种异体股骨头作为结构植骨结合肱骨近端锁定内固定系统治疗肱骨头部塌陷Neer 4部分骨折,术后头部高度丢失不明显,骨折愈合顺利,无肱骨头坏死及螺钉切出等相关并发症,术后关节功能恢复良好。 |
| [关键词]:肱骨近端骨折 同种异体骨 结构植骨 锁定钢板 手术治疗 |
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| Treatment of four-part proximal humerus fractures with depressed humeral head collapse using strut allograft with locking plates |
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Abstract:
Objective To evaluate the clinical outcomes of allogeneic femoral head as strut allograft combined with proximal humeral internal locking system (PHILOS) in the treatment of proximal humeral Neer grade Ⅳ fracture with humeral head collapse.
Methods From January 2018 to November 2020,18 patients with Neer grade Ⅳ fracture with humeral head collapse were treated with strut allograft with PHILOS,including 4 males and 14 females,aged from 55 to 78 years old,with an average of (68.11±7.20) years old.The operation time,intraoperative bleeding,postoperative drainage volume,fracture healing time,neck-shaft angle and the height of the humeral head,failure of internal fixation the shoulder function at the last follow-up was assessed using Neer's scoring system.
Results All 18 patients were followed up,and the duration ranged from 10 to 12 months,with an average of (11.08±0.65) months.The operation time was (66.44±5.06) min,the intraoperative bleeding volume was (206.67±36.14) ml,the postoperative drainage volume was (76.11±9.63) ml,and the fracture healing time was (17.28±3.92) weeks.At the last follow-up,the degree of loss of neck-shaft angle was (5.44±0.86)° and the loss of the height of humeral head was (1.43±0.27) mm.All 18 patients had healing without complications such as fracture,withdrawal,penetration of internal fixation and necrosis of humeral head.According to Neer's evaluation standard,the total score was (89.61±5.60),10 cases got an excellent result,6 good,2 fair.
Conclusion Allogeneic femoral head combined with PHILOS is an appropriate treatment for the four-part proximal humerus fractures with humeral head collapse,exhibiting good clinic outcome. |
| KEYWORDS:Proximal humeral fractures Allogeneic bone Strut allograft Locking plate Surgical treatment |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘磊,杨峰,纵成成,陈静.同种异体结构植骨加锁定钢板治疗肱骨头塌陷的Neer 4部分骨折[J].中国骨伤,2023,36(2):116~119 |
| 英文格式: | LIU Lie,YANG Feng,ZONG Cheng-cheng,CHEN Jing.Treatment of four-part proximal humerus fractures with depressed humeral head collapse using strut allograft with locking plates[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(2):116~119 |
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